Will HEDIS Prevent Payment and Increase Barriers for Low Back X-Rays?
What if there were a simple, no-cost step that could keep both your members’ practices and the chiropractic profession off of the radar? Federal health plans set the standard for reimbursement for all insurance carriers. They are evaluated based on their performance in a program called HEDIS, which seeks to improve healthcare outcomes and reduce costs. One of the measures they are evaluated on is the use of imaging studies for low back pain. If they get a bad rating, they will likely impose more conditions (i.e., pre-authorization, denied claims, increased documentation requests) on providers who take low-back films, making it harder for DCs to get paid. But you can find out the criteria that are used in order to make sure that your X-rays are medically appropriate and therefore reimbursable. Tune in to this action-packed presentation to find the answers you need to get paid and get along with payers all at the same time.