With advances in technology and medicine, the concept of “teleradiology” has become very popular. In fact, it has been increasingly utilized by more and more radiology groups, and even hospitals, over the past decade. Radiology groups across the country have found it hard to resist the tempting concept of supplemental and/or 24-hour coverage, especially for those groups that find themselves stretched thin with an overwhelming volume of work or for those located in rural areas. While the pros of teleradiology can many times out-weigh the cons, understanding the definition of teleradiology and how it’s best utilized, and then following a measured on-boarding process, are some of the keys in ensuring there are no disruptions in revenue. To clear up any initial confusion about what makes a radiologist a “teleradiologist”, think of it this way-whether hired through a telerad company or individually contracted, a teleradiologist is a physician reading remotely from the site in which the procedure or service is being performed, whether it is one locality away, or seven states away.
Location, location, location
First and foremost, the American College of Radiology requires that those physicians interpreting images in other states be licensed in both the state where the image was generated as well as the state where the interpretation takes place. When entertaining the idea of utilizing teleradiologists, it is important to check with your chosen “telerad” company about which physicians they are planning to put on your group’s reading rotation so that it can be ensured those physicians are licensed to practice for your state. It is also important to note that, even if the physician is licensed in your state, Medicare will not pay for physician interpretations that are performed outside the U.S. Once the physicians reading locations and licensure are confirmed, the process for linking them to your group can begin. If your group chooses to forgo a telerad company and employ individual teleradiologists in other locations, the same concept would apply – it will be essential to make sure the individuals are licensed for the state in which the group is based.
Your billing company should work directly with your chosen telerad company to ensure the linking and on-boarding process is smooth and successful. The success of the on-boarding process, however, hinders on the respective telerad company’s timeliness in informing both the billing company and the practice of the telerad’s “start date” with the group (meaning the date that they will begin interpreting studies), and on confirming the respective telerad’s enrollment status with the group’s major payers. Breaking this down a bit, this means that the telerad company should be informing the billing company (whether directly or through the group) at least three months before the physician begins reading. Three months allows the billing company to confirm that the telerad is enrolled with the group’s top payers (and communicate with the telerad company if enrollments are needed), linked to the group (which the billing company can complete on behalf of the group), and helps ensure the necessary system set-ups are in place. Less than three months’ notice could result in potentially higher holds and delayed revenue for the group if enrollment or linking cannot be completed for each payer before the physician begins reading. Keep in mind, if employing teleradiologists individually and unaffiliated with a telerad company, the same coordination and communication will need to take place. In many respects, the absence of a telerad company requires that the telerads themselves (and the group) become more directly involved in the communication regarding enrollment and linking process. Groups should also consider capping the number of telerads they are choosing to add to their groups by evaluating the volume of work needing coverage and planning accordingly. This can be negotiated into the contract with the telerad company. Adding too many telerads at one time will inevitably result in a more complicated enrollment and linking processes, and thus the risk of delayed or lost revenue will increase.
ADVOCATE has shown its commitment to “lean-in” with the ever-increasing trend of teleradiology, as it has shown to benefit our clients and continues to be a prevalent topic in the industry. If you believe working with a teleradiology company is a fit for your group, don’t hesitate to bring the topic up with your ADVOCATE Client Manager.