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.

HeartFlow Plaque Analysis

AI-based coronary plaque assessments 1 step closer to Medicare coverage

According to a new proposal, using AI to evaluate CCTA results and quantify plaque buildup is “reasonable and medically necessary” in certain clinical scenarios.

U.S. News & World Report children’s hospitals cardiology heart surgery

New one-stop cardiology clinic focuses on patient relationships, not insurance

A cardiologist in Billings, Montana, says her new-look practice was designed to reach patients faster and ditch unnecessary red tape. Patients pay an upfront fee, and insurance does not play a role in treatment decisions.

lex Sandhu, MD, MS, assistant professor of cardiovascular medicine, Stanford University, and cardiologist at the Palo Alto VA. He spoke in the business of cardiology sessions at ACC 2024 and explained how Medicare reimbursements will be moving toward a value based payment model by 2030. #ACC #ACC24 #ACC2024 #CMS #reimbersements #Medicare

How the shift to value-based reimbursements could transform cardiology

"I think we really need our cardiologist community to understand the changes that are happening with value-based payment," one expert tells Cardiovascular Business. 

doctor's open hand waiting for a payment

‘Concerning’ data connect industry payments to cardiologists with medical device use

U.S. physicians often receive payments from medical device manufacturers and pharmaceutical companies. New research in JAMA found a connection between receiving such payments and using specific devices—should the industry be concerned? 

Medicare money payment reimbursement dollar decline george washington

Medicare reimbursement down 29% for cardiologists, 58% for heart surgeons

Physician payments are down slightly across the board, but they've fallen significantly for a handful of specialties. Researchers examined the long-term impact this trend could have on patient care.

Alison Bailey, MD, FACC, chief of cardiology, Centennial Heart at Parkridge Medical Center, and a physician director of cardiovascular disease for HCA Healthcare. She was the co-chair of a four-part series on the business of cardiology sessions at ACC 2024. She explains why ACC chose to concentrate on business. #ACC #ACC24 #ACC2024 #Cardiologybusiness

Why the business side of cardiology was a key focus at ACC.24

Alison Bailey, MD, co-chair of the business of cardiology sessions at ACC.24, emphasized that reimbursement cuts can have a long-term negative impact on patient. 

Video interview with ACC President Cathie Biga on goals for college over the next year and trends she saw at ACC 2024.

New ACC President Cathie Biga wants to improve quality reporting in cardiology

Biga, who originally trained as a nurse, specializes in the business side of cardiology. She also emphasized the increasing importance of AI and other new technologies. 

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New Jersey cardiologist faces up to 10 years in prison for $1.9M fraud scheme

The doctor, 76, admitted to billing multiple insurance providers for office visits that never happened at all.

Around the web

Several key trends were evident at the Radiological Society of North America 2024 meeting, including new CT and MR technology and evolving adoption of artificial intelligence.

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