Practice Management

Hello All,
One of our hospitals recently asked if we would contract with Covera. I have some concerns about this, mainly that a tech firm will be directing patient care based on a radiologists fellowship. I have radiologists that are not fellowship trained but they're extremely experienced experts in many areas of radiology. There has never been any medical staff concerns or referral concerns.  I'm also concerned how an agreement with Covera will direct my after-hour patients whose studies are read by these general radiologists. Will they delay care for the exam to be read by a sub-specialized rad?  Will they have to be sent out to another facility like I read in one post? We have fellowship trained radiologists in all major areas of radiology and we do try to direct exams but we are a smaller group and the subspecialized rads aren't always on the same shift or available. 

On their initial paperwork they ask you to complete a roster of the radiologists, on it they ask what insurances are the radiologists not contracted with. I'm not sure why a company that is trying to bring high quality imaging that's based only on fellowship and total cases read needs to know about our insurance contracts? They've told me that during the determination process they will consider my request as to why the non-fellowship rads should be allowed to read certain exams. Again, I feel like this is decided by the hospital's medical staff departments and committees and it shouldn't be left to a tech firm.

I understand that they've contract with Premera BlueCross, so I see this becoming a denial tool for insurance companies in the future, but Covera reps have assured me that is not the case. I'm possibly just really over reacting to this request, so please feel free to tell me that and why. I asked Covera to provide me with some radiology groups that are contracted and they declined to do so. If you've had any experience with them I would really appreciate your feedback.

------------------------------
Roseann Pickett RT(R)(CT), CMPE
C.E.O.
Alaska Imaging
Anchorage AK
(907) 529.2210
------------------------------

Roseann - I can speak with you about this.   Too much info to type out.  
253-661-1700 x 1105 or Beth@vrads.com

------------------------------
Beth Williams MHA, FACMPE, FRBMA
Executive Director
Vantage Radiology and Diagnostic Services
Federal Way WA
(253) 661-1700 ext. 1105
------------------------------

Original Message:
Sent: 03-25-2021 18:26
From: Roseann Pickett
Subject: Covera

Hello All,
One of our hospitals recently asked if we would contract with Covera. I have some concerns about this, mainly that a tech firm will be directing patient care based on a radiologists fellowship. I have radiologists that are not fellowship trained but they're extremely experienced experts in many areas of radiology. There has never been any medical staff concerns or referral concerns.  I'm also concerned how an agreement with Covera will direct my after-hour patients whose studies are read by these general radiologists. Will they delay care for the exam to be read by a sub-specialized rad?  Will they have to be sent out to another facility like I read in one post? We have fellowship trained radiologists in all major areas of radiology and we do try to direct exams but we are a smaller group and the subspecialized rads aren't always on the same shift or available.

On their initial paperwork they ask you to complete a roster of the radiologists, on it they ask what insurances are the radiologists not contracted with. I'm not sure why a company that is trying to bring high quality imaging that's based only on fellowship and total cases read needs to know about our insurance contracts? They've told me that during the determination process they will consider my request as to why the non-fellowship rads should be allowed to read certain exams. Again, I feel like this is decided by the hospital's medical staff departments and committees and it shouldn't be left to a tech firm.

I understand that they've contract with Premera BlueCross, so I see this becoming a denial tool for insurance companies in the future, but Covera reps have assured me that is not the case. I'm possibly just really over reacting to this request, so please feel free to tell me that and why. I asked Covera to provide me with some radiology groups that are contracted and they declined to do so. If you've had any experience with them I would really appreciate your feedback.

------------------------------
Roseann Pickett RT(R)(CT), CMPE
C.E.O.
Alaska Imaging
Anchorage AK
(907) 529.2210
------------------------------

Hi Roseann,
We have been approached by two of the healthcare systems we are contracted with to partner with Covera.  We had many of the exact same concerns you voice especiallly around Covera's right to do quality reviews (per their agreement) of our reads.  In the end, one of systems signed an agreement directly with Covera (unbeknowst to us) which then did not obligate us to any of the requirements of Covera.

As Beth stated, too much more info to type out but am happy to discuss with you directly if you would like (313-359-7645) or arfarah@hbws.com.

Andy Farah

------------------------------
Andrew Farah
Director of Operations
Drs. Harris, Birkhill, Wang, Songe & Associates
Dearborn MI
------------------------------

Original Message:
Sent: 03-25-2021 18:26
From: Roseann Pickett
Subject: Covera

Hello All,
One of our hospitals recently asked if we would contract with Covera. I have some concerns about this, mainly that a tech firm will be directing patient care based on a radiologists fellowship. I have radiologists that are not fellowship trained but they're extremely experienced experts in many areas of radiology. There has never been any medical staff concerns or referral concerns.  I'm also concerned how an agreement with Covera will direct my after-hour patients whose studies are read by these general radiologists. Will they delay care for the exam to be read by a sub-specialized rad?  Will they have to be sent out to another facility like I read in one post? We have fellowship trained radiologists in all major areas of radiology and we do try to direct exams but we are a smaller group and the subspecialized rads aren't always on the same shift or available.

On their initial paperwork they ask you to complete a roster of the radiologists, on it they ask what insurances are the radiologists not contracted with. I'm not sure why a company that is trying to bring high quality imaging that's based only on fellowship and total cases read needs to know about our insurance contracts? They've told me that during the determination process they will consider my request as to why the non-fellowship rads should be allowed to read certain exams. Again, I feel like this is decided by the hospital's medical staff departments and committees and it shouldn't be left to a tech firm.

I understand that they've contract with Premera BlueCross, so I see this becoming a denial tool for insurance companies in the future, but Covera reps have assured me that is not the case. I'm possibly just really over reacting to this request, so please feel free to tell me that and why. I asked Covera to provide me with some radiology groups that are contracted and they declined to do so. If you've had any experience with them I would really appreciate your feedback.

------------------------------
Roseann Pickett RT(R)(CT), CMPE
C.E.O.
Alaska Imaging
Anchorage AK
(907) 529.2210
------------------------------

Beth and Andrew, I'd be very interested in hearing your experiences and thoughts as well, if you don't mind sharing. Thank you!

Roseanne, we're in a similar situation and agree there seem to be a lot of unanswered questions.

------------------------------
Vicki Parikh
Practice Administrator
Mid-Delaware Imaging
------------------------------

Original Message:
Sent: 03-26-2021 06:55
From: Andrew Farah
Subject: Covera

Hi Roseann,
We have been approached by two of the healthcare systems we are contracted with to partner with Covera.  We had many of the exact same concerns you voice especiallly around Covera's right to do quality reviews (per their agreement) of our reads.  In the end, one of systems signed an agreement directly with Covera (unbeknowst to us) which then did not obligate us to any of the requirements of Covera.

As Beth stated, too much more info to type out but am happy to discuss with you directly if you would like (313-359-7645) or arfarah@hbws.com.

Andy Farah

------------------------------
Andrew Farah
Director of Operations
Drs. Harris, Birkhill, Wang, Songe & Associates
Dearborn MI

Original Message:
Sent: 03-25-2021 18:26
From: Roseann Pickett
Subject: Covera

Hello All,
One of our hospitals recently asked if we would contract with Covera. I have some concerns about this, mainly that a tech firm will be directing patient care based on a radiologists fellowship. I have radiologists that are not fellowship trained but they're extremely experienced experts in many areas of radiology. There has never been any medical staff concerns or referral concerns.  I'm also concerned how an agreement with Covera will direct my after-hour patients whose studies are read by these general radiologists. Will they delay care for the exam to be read by a sub-specialized rad?  Will they have to be sent out to another facility like I read in one post? We have fellowship trained radiologists in all major areas of radiology and we do try to direct exams but we are a smaller group and the subspecialized rads aren't always on the same shift or available.

On their initial paperwork they ask you to complete a roster of the radiologists, on it they ask what insurances are the radiologists not contracted with. I'm not sure why a company that is trying to bring high quality imaging that's based only on fellowship and total cases read needs to know about our insurance contracts? They've told me that during the determination process they will consider my request as to why the non-fellowship rads should be allowed to read certain exams. Again, I feel like this is decided by the hospital's medical staff departments and committees and it shouldn't be left to a tech firm.

I understand that they've contract with Premera BlueCross, so I see this becoming a denial tool for insurance companies in the future, but Covera reps have assured me that is not the case. I'm possibly just really over reacting to this request, so please feel free to tell me that and why. I asked Covera to provide me with some radiology groups that are contracted and they declined to do so. If you've had any experience with them I would really appreciate your feedback.

------------------------------
Roseann Pickett RT(R)(CT), CMPE
C.E.O.
Alaska Imaging
Anchorage AK
(907) 529.2210
------------------------------

Original Message:
Sent: 3/26/2021 10:35:00 AM
From: Vicki Parikh
Subject: RE: Covera

Beth and Andrew, I'd be very interested in hearing your experiences and thoughts as well, if you don't mind sharing. Thank you!

Roseanne, we're in a similar situation and agree there seem to be a lot of unanswered questions.

------------------------------
Vicki Parikh
Practice Administrator
Mid-Delaware Imaging
------------------------------

Original Message:
Sent: 03-26-2021 06:55
From: Andrew Farah
Subject: Covera

Hi Roseann,
We have been approached by two of the healthcare systems we are contracted with to partner with Covera.  We had many of the exact same concerns you voice especiallly around Covera's right to do quality reviews (per their agreement) of our reads.  In the end, one of systems signed an agreement directly with Covera (unbeknowst to us) which then did not obligate us to any of the requirements of Covera.

As Beth stated, too much more info to type out but am happy to discuss with you directly if you would like (313-359-7645) or arfarah@hbws.com.

Andy Farah

------------------------------
Andrew Farah
Director of Operations
Drs. Harris, Birkhill, Wang, Songe & Associates
Dearborn MI

Original Message:
Sent: 03-25-2021 18:26
From: Roseann Pickett
Subject: Covera

Hello All,
One of our hospitals recently asked if we would contract with Covera. I have some concerns about this, mainly that a tech firm will be directing patient care based on a radiologists fellowship. I have radiologists that are not fellowship trained but they're extremely experienced experts in many areas of radiology. There has never been any medical staff concerns or referral concerns.  I'm also concerned how an agreement with Covera will direct my after-hour patients whose studies are read by these general radiologists. Will they delay care for the exam to be read by a sub-specialized rad?  Will they have to be sent out to another facility like I read in one post? We have fellowship trained radiologists in all major areas of radiology and we do try to direct exams but we are a smaller group and the subspecialized rads aren't always on the same shift or available.

On their initial paperwork they ask you to complete a roster of the radiologists, on it they ask what insurances are the radiologists not contracted with. I'm not sure why a company that is trying to bring high quality imaging that's based only on fellowship and total cases read needs to know about our insurance contracts? They've told me that during the determination process they will consider my request as to why the non-fellowship rads should be allowed to read certain exams. Again, I feel like this is decided by the hospital's medical staff departments and committees and it shouldn't be left to a tech firm.

I understand that they've contract with Premera BlueCross, so I see this becoming a denial tool for insurance companies in the future, but Covera reps have assured me that is not the case. I'm possibly just really over reacting to this request, so please feel free to tell me that and why. I asked Covera to provide me with some radiology groups that are contracted and they declined to do so. If you've had any experience with them I would really appreciate your feedback.

------------------------------
Roseann Pickett RT(R)(CT), CMPE
C.E.O.
Alaska Imaging
Anchorage AK
(907) 529.2210
------------------------------