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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Largest Medicare fraud case in DOJ history alleges $712M in false billings

On June 18, the federal government charged 243 individuals with participating in a Medicare fraud scheme totaling approximately $712 million in false billings. The Medicare Fraud Strike Force, a joint initiative between the Department of Justice (DOJ) and Department of Health and Human Services, led the investigation.

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Report finds healthcare billing, payment systems concern consumers

More than 40 percent people in fair or poor health found their medical bills were unaffordable and more than 25 percent said the bills were inaccurate and difficult to understand. The results of the PwC Health Research Institute survey were released on May 7.

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Heart monitoring service settles overbilling case for $6.4M

A company that provides outpatient cardiac monitoring agreed to pay $6.4 million to settle a case of what one federal official called “abusive billing practices.”

Probe puts billing for peripherals under microscope

Peripheral interventions by the cardiologist who captured headlines for billing Medicare $18 million are now under scrutiny, which prompted the New York Times to investigate the upsurge in peripheral stenting.

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No Margin, No Mission: A Team-Based Approach to Cath Lab Billing

Better documentation and billing practices are key to securing reimbursement, avoiding denials and protecting diminishing margins for catheterization laboratories. 

Accreditation for Cardiovascular Excellence (ACE) speaker Sheree Schroeder presents: A team based approach for billing

ACE is proud to be invited as a guest speaker at the 10th annual Complex Cardiovascular Catheter Therapeutics: Advanced Endovascular and Coronary Intervention Global Summit (C3), taking place June 23-27, 2014 at the Hilton Bonnet Creek, Orlando, Florida. Sheree Schroeder, MSN, RN, RDCS, FASE,  ACE's Director of Quality Review Services , will be speaking on the topic "No Margin, No Mission" A Team Based Approach for Billing.

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Structured Reporting: Boosting Patient Care, Refining Billing

Wolters Kluwer

Akron General Heart & Vascular Center is a leader in STEMI care in Northeast Ohio, each year besting the national average for STEMI mortality rates.

Billing code-based algorithm helps identify PAD cases

Researchers at the Mayo Clinic designed and validated an algorithm using billing codes that accurately identifies people with peripheral artery disease (PAD) in a community-based sample.

Around the web

Ron Blankstein, MD, professor of radiology, Harvard Medical School, explains the use of artificial intelligence to detect heart disease in non-cardiac CT exams.

Eleven medical societies have signed on to a consensus statement aimed at standardizing imaging for suspected cardiovascular infections.

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