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.

The ASNC team at the 2024 AMA meeting, Georgia Lawrence, JD, ASNC director of regulatory affairs; Suman Tandon, MD, FASNC, delegate to the AMA HOD and cardiac imager at NYU Langone; and Kathy Flood, ASNC CEO. #AMA #AMA24 #AMA2024 #AMAHOD #ASNC

ASNC supports AMA effort to limit use of AI in prior authorization decisions

The American Society of Nuclear Cardiology (ASNC) supports an AMA policy that condemns the use AI to make prior authorization decisions rather than a doctor or clinician.

There has been a growing shortage of cardiologists the past several years, but this has accelerated due to burnout from the pandemic, falling reimbursements and increasing administrative burdens. This prompted a joint session on this topic with the ACC and the Heart Rhythm Society at HRS 2024, with ACC President Cathie Biga, MSN, FACC, president and CEO of Cardiovascular Management of Illinois, former ACC president Ed Fry, MD, chair of the Ascension National Cardiovascular Service Line, and EP Parin Patel.

Addressing staffing shortages in cardiology

ACC President Cathie Biga, MSN, RN, Edward Fry, MD, and electrophysiologist Parin Patel, MD, discuss the growing cardiologist shortage.

Joel Sauer, MBA, MedAxoim, explains why there is a big business trend in cardiology toward remote monitoring and telehealth to cut costs. #ACC #MedAxiom #Telecardiology #remotemonitoring #ACC2024

Telemedicine, remote monitoring help reduce healthcare costs

As profit margins in healthcare continue to shrink, telemedicine and remote monitoring are seeing a large increase to help cut costs while still delivering care outside of the hospital.

physician tracking patient data and reporting on outcomes

Q&A: Cardiologist Karen Joynt Maddox on why new healthcare policies are not improving outcomes

Healthcare's ongoing shift toward value-based care is a good thing, Joynt Maddox explained, but its implementation has been far from ideal. She also discussed population health, the pandemic, health disparities and the rising influence of private equity investments.

Drawing inspiration from the World War II “Why We Fight” campaign that rallied support for the U.S. war effort, American Medical Association (AMA) President Jesse M. Ehrenfeld, MD, MPH, drew comparisons with the uphill battles physicians are facing today with dwindling reimbursements, physicians shortages, burnout and administrative fights against prior authorization burdens and attempts to preserve access to telehealth. #AMA #AMAHOD24 #AMAHOD2024 #HOD #HOD24 #HOD2024

AMA president calls for physicians to take war-time footing in fight over reimbursement, care quality

Drawing inspiration from the World War II “Why We Fight” campaign that rallied support for the U.S. war effort, AMA President Jesse  Ehrenfeld, MD, spoke on the uphill battles physicians are facing today.

How cardiologists and hospitals get paid via RVUs and DRGs There has been an increasing number of "business of cardiology" sessions are several cardiology conferences over the past two year as reimbursements continue to decline and costs continue to increase. Chief among the topics discussed has been how to navigate the intricacies of how cardiologists and hospitals are reimbursed. One of these speakers was Joel Sauer, MBA, executive vice president of consulting, MedAxiom, who spoke at the American Colle

How cardiologists and hospitals get paid

Joel Sauer, MBA, executive vice president of consulting with MedAxiom, reviews the intricacies of how cardiologists and hospitals are reimbursed.

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.

Around the web

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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.