Revenue & Reimbursement

Healthcare reimbursement is payment that a hospital, diagnostic imaging facility, subspecialty department or healthcare providers receive for performing a service. This also includes individual radiologist or cardiologist reimbursement and billing and coding rules for submitting claims.

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Rebecca Farrington and Sandy Coffta explain different approaches to the main issues facing radiology during a presentation at RBMA 2024. #RBMA $RBMA24 #RBMA2024

Strategies to solve the toughest issues facing radiology practice management

Rebecca Farrington and Sandy Coffta from Healthcare Administrative Partners explain how to best tackle real-world issues radiology practices are facing.

April 23, 2024
Dave Walker explains how AI is helping improve the revenue cycle in radiology. #RBMA #RBMA24 #RBMA2024

Use of AI in radiology revenue cycle management

Dave Walker, senior director of revenue cycle, Radiology Associates of North Texas, explains how his practice uses artificial intelligence for revenue cycle management during the Radiology Business Management Association (RBMA) 2024 meeting.

April 22, 2024
Radiology Business Management Association (RBMA) President Christopher (Kit) Crancer, senior vice president of radiology and public policy partnerships, and executive director of the Rayus Quality Institute, explains the highlights from the 2024 RBMA meeting.

Highlights from RBMA's 2024 PaRADigm annual meeting in Las Vegas

Radiology Business Management Association (RBMA) President Christopher Crancer shared some early highlights from the group's 2024 PaRADigm annual meeting in Las Vegas. "We have a very engaged membership," he said. 

April 16, 2024
Former managers of a Tampa Florida-based radiology company Advanced Diagnostic Group (ADG) and its employee stock ownership plan (ESOP) retirement benefit manager GreatBanc Trust Co. will pay $19 million to settle a class action lawsuit. The suit alleges they allowed the ESOP’s value to be diverted to managers, directors and their shell companies and away from employee participants. money gavel court lawsuit legal judge judgement

Former radiology group employees settle lawsuit over retirement benefits for $19M

About 180 former employees settled a suit with the former managers and owners of their radiology practice, saying their retirement benefits were mismanaged. 

April 1, 2024
An example of cardiac MRI myocardial blood flow reserve (MBFR) imaging. Image courtesy of https://doi.org/10.3390/diagnostics10090679

Imaging group thrilled with new CPT codes for MBFR measurements

The Society for Cardiovascular Magnetic Resonance applauded two new CPT Category III codes for myocardial blood flow reserve (MBFR) assessments.

February 16, 2024
Melissa Chen, MD, Clinical Neuroradiologist, Associate Professor, University of Texas MD Anderson Cancer Center, said challenges ton radiology include the limitations of the relative value units (RVUs) used to pay radiologists, the need for balancing workloads despite disincentives to reading some studies, and the need to find new workflow efficiencies with AI to offset the radiologist shortage. #RSNA

Radiology at tipping point with limitations of RVUs and the growing shortage of radiologists

Melissa Chen, MD, MD Anderson Cancer Center, outlines some of the challenges practices are facing and possible solutions.

January 31, 2024

HeartFlow’s AI-powered CAD offering receives new CPT code with improved reimbursement rate

For this update to be finalized, the American Medical Association had to determine FFRCT Analysis met certain requirements in terms of its overall impact on patient care. John Farquhar, CEO of HeartFlow, described the news as "a win for everyone involved, most notably patients." 

January 24, 2024
Richard Heller, MD, RSNA Board member, associate chief medical officer for health policy and communications, and national director of pediatric radiology at Radiology Partners, explains some insurance companies are trying to take advantage of the No Surprises Billing Act by telling radiology practices they need to accept lower rates to remain part of the providers in-network.

Radiologists urged to report insurance companies forcing lower reimbursements due to No Surprises Act

Some payers are taking advantage of the NSA by forcing practices to accept lower rates to remain in-network, says Rad Partners' Richard Heller, MD. 

January 18, 2024
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Medicare drops AUC requirement for advanced imaging, ASNC celebrates

"This was an unneeded burden, which was solely adding to the administrative hassles of medicine," said American Society of Nuclear Cardiology President Larry Phillips.

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Cardiology, radiology groups urge insurance provider to rethink imaging policy

SCAI and four other major healthcare organizations signed a joint letter in support of intravascular ultrasound. 

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Radiology AI company gains FDA clearance for new CT offerings focused on PE, stroke

The newly approved AI models are designed to improve the detection of pulmonary embolisms and strokes in patients who undergo CT scans.

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