decisionhealth Newsletters, Coder Pink Sheets - 2007 Issue 2 (February)
UHC sets new imaging accreditation requirement
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Article Overview
This article covers a UnitedHealthcare payment policy change tied to accreditation for outpatient imaging in physician offices and freestanding imaging centers. It is aimed at practice administrators, orthopedics and other physician groups that perform imaging in-house, and it discusses the general scope of the affected modalities, the accreditation organizations recognized by the payer, timing, and practical considerations for practices preparing for the change.
Why This Topic Matters
The policy may affect reimbursement for practices that perform imaging services in-house, making accreditation status an operational and financial issue for affected providers.
Article Sections
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Imaging accreditation requirement
Overview of the payer policy change and the types of practice settings and services implicated. The section frames the scope of the new accreditation expectation and its timing.
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Affected imaging modalities
Broad coverage of the categories of imaging services referenced as part of the policy. It notes that several modalities are included and that one common imaging type is not listed.
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What must be accredited
General discussion of how accreditation applies across sites and service locations within a practice. It addresses the organizational scope of the requirement.
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Recognized accreditation organizations
Identification of the external organizations the payer will accept for accreditation. The section provides context for practice selection and implementation planning.
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More payers likely to follow
Commentary on the possibility that other payers may adopt similar expectations. The section places the policy in a broader payer trend context.
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Expect expense & a tough process
High-level discussion of the administrative effort, time, and cost associated with obtaining accreditation. It also highlights practice workflow considerations and preparation.
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First step: Get educated on both the ACR and IAC programs
Practical preparation guidance focused on learning about the available accreditation programs and planning ahead. The section emphasizes early implementation steps without detailing selection criteria.
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Resources
Links and references to the payer announcement and the organizations named in the article. This section serves as a source directory for follow-up information.
What You Will Learn
- Which types of outpatient imaging services are affected by the policy change
- Which practice settings may need to consider accreditation
- Which organizations are recognized for accreditation under the policy
- What operational factors practices should anticipate when preparing for accreditation
- Why the policy may matter beyond one payer
Who Should Read This
- Orthopedic practices
- Physician practice administrators
- Radiology and imaging center managers
- Billing and revenue cycle staff
- Practice compliance staff
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