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In
a July 13, 2004 letter to all providers, Highmark Blue Cross
Blue Shield announced that, effective January 1, 2005, all
providers of diagnostic imaging services performed outside of
a hospital setting will be required to adhere to new privileging
guidelines. As detailed below, guidelines now exist related
to each of the accrediting bodies within the Intersocietal Accreditation
Commission: the ICAEL, the ICAVL and the ICANL.
According
to Augusta L. Kairys, Vice President of Provider Relations for
Highmark Blue Cross Blue Shield, "These guidelines have
been developed to promote reasonable and consistent quality
and safety standards for the provision of imaging services."
The
new privileging guidelines apply to most Highmark health plans
in Western Pennsylvania (29 counties). Highmark plans to implement
the program in Central Pennsylvania (21 counties) at a later
date. Highmark has signed an agreement with National Imaging
Associates, Inc., a national radiology management company, to
help implement the program.
GUIDELINES
SPECIFIC TO ECHOCARDIOGRAPHY
- Echocardiography
must be performed by physicians credentialed by Highmark and/or
Keystone Health Plan West in diagnostic radiology or cardiology.
- Echocardiography
systems must have color flow Doppler capability.
- Echocardiography
practices must achieve accreditation by the ICAEL (Intersocietal
Commission for the Accreditation of Echocardiography Laboratories)
within two years of provisional acceptance in the Privileging
Program. [NOTE: Practice must submit evidence of application
for accreditation within 3 months of receipt of the letter
indicating provisional acceptance.]
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