Dave,
We acquired the servicing of an inner city hospital in the East St. Louis area with a high uninsured transient population. The hospital receives IL State and Federal funding.
The payment arrangement is an addendum to the PSA. The hospital grouped the CPT codes. We negotiated different dollar amounts for each CPT group.
Operationally, our docs perform the IR procedures or read the diagnostic cases and the dictation is sent to our billing company via HL7 just like the rest of our hospitals. Our billing company identifies the hospital location and puts a hold on the patient account. The hospital sends a check the next month along with a report with the details of each study (DOS, PT, CPT, Pmt amount) performed that prior month. Our billing company reconciles that report against the studies received during the month via our HL7 interface.
It's guaranteed pmt on 100% of the studies, and a steady income stream.
Please contact me directly if you have any additional questions.
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Tim Hollingsworth
Business Manager
Central Illinois Radiological Associates
East Peoria IL
thollingsworth@cirarad.net------------------------------
Original Message:
Sent: 04-08-2019 14:24
From: David Smith
Subject: IR at a Public/Safety Net Hospital
Our private practice has been approached by another group to provide some limited specialized IR services for patients at a quasi-public/safety net hospital with a high uninsured population. Based on preliminary conversations, the hospital is apparently willing to pay for the service, so there would be no patient billing involved.
If anyone else has entered into such an arrangement, I would be interested in talking with you about how it was set up financially and operationally.
I would also be interested in learning about arrangements, if they exist, where the safety net hospital sends specialized cases to a private hospital, and how those are set up financially (a la the VA fee based program that contracts with private hospitals for services they don't have in house). Given the fact that the hospital is willing to pay for our services in order to do more of these cases, I presume there is a funding source somewhere.
Feel free to email me directly off the list if you have some insight on this. dsmith@uickc.com.
Thanks!
Dave
David Smith, FACMPE | Executive Director | 785.393.8387
