UnitedHealthcare extends accreditation period for imaging reimbursement

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UnitedHealthcare (UHc) will require all facilities performing diagnostic imaging to obtain appropriate accreditation by third quarter 2008, in order to continue receiving reimbursements for many imaging procedures. The deadline had previously been March 1.

However, recent data from the insurer indicates that overall, less than half of the health plan’s imaging providers have yet to complete the process, the American College of Radiology (ACR) reported. The payor also said that currently, only approximately half of the plan’s MRI, nuclear medicine and CT providers are accredited while nearly two-thirds of PET providers have completed the accreditation process.

In order to comply with the UHc deadline and ensure reimbursement for diagnostic imaging services is not compromised, ACR is recommending that facilities begin the accreditation process immediately.

UHc has recognized the ACR and the Intersocietal Accreditation Commission as acceptable accrediting organizations for medical imaging, and has designated the following modalities as falling under the mandate: CT, CT angiography, MRI, MR angiography, PET, nuclear medicine/cardiology and echocardiography.

All providers performing the procedures will need to submit a completed application for accreditation by UHc’s deadline, the ACR reported. The college also said that facilities will then have 12 months from the date of submission, in which reimbursements will not be stalled, provided that their accreditation is underway.