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.

Medicare money payment reimbursement dollar decline. More than 100 U.S. medical societies are throwing their support behind a new proposal that could reform out-of-date Medicare policies and help limit future payment cuts. 

Cardiologists speak out about reimbursement cuts, say Congress ‘left clinicians holding the bag’

When Congress passed its latest continuing resolution to avoid a government shutdown, it provided no relief for cardiologists and other physicians impacted by ongoing Medicare reimbursement cuts. The American College of Cardiology responded to this development with yet another plea for change. 

January 22, 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
Video interview with Radiology Business Management Association (RBMA) President Kit Crancer, and executive director of the Rayus Quality Institute, where he said the lack of federal policy on insurance coverage for diagnostic breast exams as opposed to screening exams

State legislation addresses gaps in breast imaging coverage, ensures affordable diagnostic exams

RBMA President Kit Crancer said a lack of federal policy has driven 20 states to adopt laws requiring that insurance cover the costs. 

January 11, 2024
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Cardiologists make a familiar plea, urging Congress to eliminate impending Medicare cuts

Congress has already adjourned for the year without taking action, but U.S. medical societies are hoping relief from significant Medicare cuts will arrive in early 2024. 

December 21, 2023
healthcare money economics dollar stethoscope acquire merger

Philips-owned BioTelemetry to pay nearly $15M for allegedly misleading clinicians to secure higher reimbursements

The company and one of its subsidiaries would allegedly confuse clinicians and have them bill government programs for cardiac monitoring services that were more expensive than what they needed. This settlement resolves those allegations. 

December 20, 2023
Peter Moffatt, RBMA president-elect, discusses biggest issues facing radiology practices at RSNA 2023. #RBMA #RSNA #Radiology #CMScuts

Navigating the crucial challenges in radiology practice management

RBMA President-elect Pete Moffatt discusses how to contend with challenges such as staff shortages and reimbursement issues.

December 20, 2023
Video interview with 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 the impact of the 2024 Medicare cuts on radiology and what comes next. #RSNA #RSNZA23 #RSNA2023 #CMS #Radiology

Putting US radiology reimbursement cuts in context and what comes next

Richard Heller, MD, a member of the RSNA Board and associate CMO for Rad Partners, explains the impact of the 2024 Medicare cuts and what is at stake.

December 11, 2023
insurance

Cardiologists lead push for Aetna to reconsider ‘restrictive,’ ‘inconsistent’ reimbursement proposals

The policies cover a wide range of interventional therapies, including Shockwave Medical's IVL technology and intravascular ultrasound. 

December 6, 2023

Around the web

The recall includes specific lots of five different medical devices used to treat stroke and other neurovascular diseases.

The agency is urging healthcare providers to transition away from these devices and seek out alternatives. It is even working with other manufacturers to try and get similar products on the market as quickly as possible. 

Jeffrey Kuvin, MD, one of the leading voices behind efforts to create a new Board of Cardiovascular Medicine, spoke with Cardiovascular Business about where things stand today.

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