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Accreditation Countdown: If You Are Billing Medicare the Technical Component for Advanced Diagnostic Imaging, You Better Get Started

Posted by Mary Pat Whaley on July 24, 2011

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If you are a physician, non-physician practitioner or Independent Diagnostic Testing Facility (IDTF) who supplies imaging services and submits claims for the Technical Component (TC) of Advanced Diagnostic Imaging (ADI) procedures to Medicare contractors (carriers and A/B Medicare Administrative Contractors (MACs)), you should know that you must be accredited by Sunday, January 1, 2012. If your facility uses an accredited mobile facility, and you bill for the TC of ADI, you must also be accredited. The accreditation requirement is attached to the biller of the services.

Those not accredited by that deadline will not be able to bill Medicare until they become accredited.

For those planning on seeking accreditation to continue performing the technical component of ADI services, know that accreditation is dependent on the demonstration of quality standards, including (but not limited to):

Qualifications and responsibilities of medical directors and supervising physicians;

Qualifications of medical personnel who are not physicians;

Procedures to ensure that equipment used meets performance specifications;

Procedures to ensure the safety of beneficiaries;

Procedures to ensure the safety of person who furnish the imaging; and

Establishment and maintenance of a quality assurance and quality control program to ensure the reliability, clarity and accuracy of the technical quality of the image.

Additionally, the accreditation process may include:

(more…)

Tags: 855B, 855I, accreditation organization, ADI Medical Director, ADT, advanced diagnostic imaging, American College of Radiology, AO, CMS, CT, fluoroscopy, IDTF, Independent Diagnostic Testing Facility, Intersocietal Accreditation Commission, January 1 2012, MACs, Medicare Administrative Contractor, MIPPA, mobile imaging facility, MRI, Nuclear medicine, physician fee schedule, professional component, prospective payment system, Radiation Safety of Beneficiaries, TC, technical component, The Joint Commission

Posted in: Medicare & Reimbursement

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Deja Vu All Over Again: The Medicare Fee Cut is Pushed Back to November 30, 2010

Posted by Mary Pat Whaley on June 24, 2010

I don’t know about you but I am emotionally exhausted thinking about and worrying about the on-again off-again cuts in Medicare fees for physicians.

Here’s the scoop: late Thursday evening, June 24, 2010, the House of Representatives passed the ” Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010 (H.R. 3962)” which includes a delay in the 21+% fee cut. Because the same legislation was already passed by the Senate, it now goes to the President for his signature and it becomes law. It is anticipated that this will happen quickly and CMS will have the MACs start processing new claims with dates of service of June 1, 2010 and later at the 2009 fee schedule plus a 2.2% increase. The MACs will also have to reprocess the claims already paid for dates of service June 1, 2010 and later that were processed with 2010 fee schedule and that big fat cut.

Q: What should we be doing for the next 5 months and 6 days?

WASHINGTON - SEPTEMBER 10: Doctors and other ...

Image by Getty Images via @daylife

A: Have someone in your practice take a video of your providers introducing themselves, telling how many Medicare patients they have and how they can’t afford to see Medicare patients unless the SGR formula is replaced with something that works. The video doesn’t have to be slick – just real. Send it to your senators and representatives. Send it your local TV news. Post it on YouTube. Imagine hundreds of thousands of providers introducing themselves and talking about their patients. It would be powerful.