Nonradiologist Ordering

Reimbursing Qualified Practitioners Only

Nonradiologists perform an increasing number of imaging exams. Research studies show that liberally reimbursing imaging tests performed by physicians outside their specialties leads to overuse, diagnostic errors, and lower image quality. In response to this trend, HealthHelp’s nonradiologist ordering program, Scope™, safeguards test quality and deters unnecessary imaging.

Scope makes sure reimbursed imaging services are provided by physicians trained in accredited medical schools for specific imaging procedures. Payers receive policies written in CMS format. Insurers also get evidence-based information for designating CPT codes so each of forty-three groupings of physicians can bill and be paid for radiology services. For example, orthopedic surgeons can perform plain radiographic studies of the spine, joints, and extremities but not other types of imaging exams.

HealthHelp personnel also conduct audits to ensure physicians are not reimbursed for imaging services they are not authorized to perform.