Journal of the American College of Radiology
Volume 6, Issue 12 , Pages 844-850 , December 2009

Strategies for Managing Imaging Utilization

  • Mark Bernardy, MD

      Affiliations

    • Conyers, Georgia
  • ,
  • Christopher G. Ullrich, MD

      Affiliations

    • Charlotte Radiology PA, Charlotte, North Carolina
  • ,
  • James V. Rawson, MD

      Affiliations

    • Department of Diagnostic, Therapeutic and Interventional Radiology, Medical College of Georgia, Augusta, Georgia
  • ,
  • Bibb Allen Jr, MD

      Affiliations

    • Birmingham Radiological Group, PC, Birmingham, Alabama
    • Department of Radiology, Trinity Medical Center, Birmingham, Alabama
  • ,
  • James H. Thrall, MD

      Affiliations

    • Massachusetts General Hospital, Boston, Massachusetts
  • ,
  • Kathryn J. Keysor, BS

      Affiliations

    • American College of Radiology, Reston, Virginia
    • Corresponding Author InformationCorresponding author and reprints: Kathryn J. Keysor, BS, American College of Radiology, 1891 Preston White Drive, Reston, VA 20191
  • ,
  • Christie James, MS

      Affiliations

    • Massachusetts General Hospital, Charlestown, Massachusetts
  • ,
  • John A. Boyes, MD, MBA

      Affiliations

    • Mount Vernon, Washington
  • ,
  • Worth M. Saunders, MHA

      Affiliations

    • Mid-South Imaging & Therapeutics, PA, Memphis, Tennessee
  • ,
  • Wendy Lomers, CPA, MBA

      Affiliations

    • Radiology Associates of San Antonio, PA, San Antonio, Texas
    • Advanced Medical Imaging Centers, FlexRad, San Antonio, Texas
  • ,
  • Daniel J. Mollura, MD

      Affiliations

    • Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland
  • ,
  • Robert S. Pyatt Jr, MD

      Affiliations

    • Chambersburg Hospital, Chambersburg, Pennsylvania
  • ,
  • Richard N. Taxin, MD

      Affiliations

    • Crozer Chester Medical Center, Upland, Pennsylvania
  • ,
  • Michael R. Mabry, MA

      Affiliations

    • Radiology Business Management Association, Fairfax, Virginia

References 

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  16. UnitedHealthcare. Radiology notification. https://www.unitedhealthcareonline.com/b2c/CmaAction.do?channelId=71a436d4b6e32110VgnVCM100000c520720a____Accessed June 29, 2009
  17. Iglehart JK. Health insurers and medical imaging policy—a work in progress. N Engl J Med. 2009;360:1030–1037
  18. Casalino LP, Nicholson S, Gans DN, et al. What does it cost physician practices to interact with health insurance plans?. Health Aff. 2009;w533–w543
  19. Duszak R. Deauthorization: the insidious new payer trick. J Am Coll Radiol. 2006;3:713–715
  20. Medicare Payment Advisory Commission. Report to the Congress: Medicare payment policy. http://www.medpac.gov/publications/congressional_reports/Mar05_EntireReport.pdfAccessed September 22, 2009
  21. Friedman DP, Smith NS, Bree RL, Rao VM. Experience of an academic neuroradiology division participating in a utilization management program. J Am Coll Radiol. 2009;6:119–124
  22. Sakowski JA, Kahn JG, Kronick RG, Newman JM, Luft HS. Peering into the black box: billing and insurance activities in a medical group. Health Aff. 2009;w544–w554
  23. UnitedHealthcare. Imaging accreditation. https://www.unitedhealthcareonline.com/b2c/CmaAction.do?channelId=dda436d4b6e32110VgnVCM100000c520720a____Accessed June 29, 2009
  24. AllBusiness. Magellan Health Services to convert radiology management contract with Empire Blue Cross Blue…. http://www.allbusiness.com/services/business-services/4302265-1.htmlAccessed June 29, 2009
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  26. Mammography Quality Standards Act of 1992. Pub L No 102-539. As amended by the Mammography Quality Standards Reauthorization Act of 1998, Pub L No 105-248, Title 42, Subchapter II, Part F, Subpart 3, § 354 (42 USC 263b), certification of mammography.
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  28. Medicare Improvements for Patients and Providers Act of 2008, Pub L No 110-275, Subtitle C, Part I, § 135, imaging provisions.
  29. Deficit Reduction Act of 2005, Pub L No 109-171, § 5102(b), 120 Stat. 4, 39-40 (2006).
  30. US Government Accountability Office. Medicare: trends in fees, utilization, and expenditures for imaging services before and after implementation of the Deficit Reduction Act of 2005 (GAO-08-1102R). http://www.gao.gov/new.items/d081102r.pdfAccessed September 22, 2009

 C.G. Ullrich is a member of the Optinet Advisory Panel of American Imaging Management and a member of the Diagnostic Imaging Advisory Group of NC Blue Cross Blue Shield. J.H. Thrall is chairman of the board of Mobile Aspects and an equity partner. J.A. Boyes is a consultant with RadMetrices. W. Lomers is a staff member of Radiology Associates of San Antonio.

PII: S1546-1440(09)00393-7

doi: 10.1016/j.jacr.2009.08.003

Journal of the American College of Radiology
Volume 6, Issue 12 , Pages 844-850 , December 2009