Reimbursement

Medical practices are increasingly pressured to showcase the details of their contribution to medicine. But radiology isn’t like most other medical specialties, is it?

Here’s the thinking behind Anthem/AIM’s decision to steer certain advanced imaging procedures out of hospital settings.

Since the introduction of the concept of an interventional radiology ambulatory surgery center (“irASC”) in 2016, there’s been an explosion in the number of billing codes that permit irASCs to collect for outpatient interventional procedures.

As reimbursement challenges grow for outpatient imaging, many practices are struggling to remain afloat. However, with the right technology, it’s very possible to stay ahead of the curve.

April 16, 2015, marked the beginning of a seismic shift in the healthcare landscape. On that day, the U.S. Senate passed H.R. 2, the MACRA, which repeals the SGR formula, extends the CHIP for two years, institutes a 0.5% increase in Medicare reimbursement over the next four and a half years and encourages physicians to transition to APMs.

Radiology has been hit hard by reimbursement cuts and regulations but the cutting-edge tools available are helping practices stay ahead of all the changes impacting the market.

The practice has identified a billing error or a compliance problem impacting Medicare coverage that resulted in the practice having received an overpayment from Medicare.