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While the ICAEL attempts to stay abreast of reimbursement policies as a service to the echocardiography community, these policies are changed and updated regularly by the carriers. Therefore, the ICAEL recommends that you contact the insurance carriers in your area for the most accurate and current information. (These numbers are available through your hospital or laboratory's billing department.)
Medicare Payment Policies
There are several states in which the Medicare carrier requires either accreditation of the laboratory and/or sonographer credentialing, for reimbursement of echocardiography studies. Medicare communicates echocardiography payment policy primarily through contractor-specific Local Coverage Determinations (LCDs).
As of 6/1/2010, the ICAEL is currently updating the listing of specific payment policies generally published within this section. Please check back in the near future to view a listing of Medicare payment policies, by state.
To access the LCDs, and for the purpose of conducting your own research, utilize the following link on the Centers for Medicare and Medicaid (CMS) website:
http://www.cms.gov/mcd/index_lmrp_bystate_criteria.asp?error=A+State+must+be+selected.
Private, Third-Party Insurer Payment Policies
The ICAEL is aware of the following private insurers with payment policies requiring accreditation for echocardiography studies.
Horizon BCBS NEW | United Healthcare UPDATED | Tufts Health Plan
Highmark BCBS (PA) | Aetna (NY, NJ) | Anthem BCBS of ME
If you are aware of additional payment policies, or have questions about the information posted, please email Tamara Sloper, Marketing Director.
Beyond Reimbursement
In addition to the details discussed above, it is important to stress that a large percentage of echocardiography laboratories participate in the accreditation process on a voluntary basis regardless of whether it is a requirement for reimbursement. In a recent survey to newly accredited ICAEL laboratories, the majority of the 500+ respondents indicated that they found (1) improvements to patient care experienced through the internal self assessment, (2) improvements to patient care experienced through feedback from the peer-review process and (3) marketing benefits to the laboratory to be as equally beneficial as compliance with insurance carriers' payment policies. These responses serve to validate the multitude of benefits associated with participation in the ICAEL accreditation process, beyond reimbursement implications. Not to be underestimated is the most important of these -- the improvement in the quality of patient care provided by the echocardiography laboratory.
The ICAEL looks forward to working with you to achieve accreditation for your echocardiography laboratory. |
