Advancing the Business of Radiology
The leading professional organization for radiology business management professionals in any radiology setting.
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Welcome, Leaders!

As a practice leader, you have come to the right place for radiology business professionals who are dedicated to supporting and enhancing their vocation, investing in their career and pursuing higher goals. You have the respect of your physicians to help guide, develop and maintain a practice/department and you strive to advance the profession and improve the business of healthcare.

RBMA is the place to turn for inspiration, resources and practical tools you can’t find anywhere else.

Leaders
“The RBMA provides critical information through expertise and dedication to the field of radiology business. Being a member of RBMA as an administrator has provided me with the most up to date information and networking opportunities to assist me in performing at the highest level.”

More Resources For Practice Leaders:

Resources For Leaders

Register now for DataMAXX for reliable and immediate data to make the right operational decisions, optimize resources, continuously improve performance and develop a strategy for the future

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Welcome, Radiology Business Managers!

As a manager you have come to the right place for information and resources that will assist you in coding properly and obtaining the best possible reimbursement for your practice.

RBMA connects radiology business managers with resources and practical tools to help you succeed.

Manager
“I have been in the radiology business for 34 years and have seen many changes. One of the best changes is how the RBMA has grown and provides us with the necessary tools that we need in order to help us continue on this rocky road.”

More Resources For Managers:

Conference Audio Recording

Articles

Resources For Managers

DataMAXX

RBMA U

Enroll in RBMA U’s Radiology Business 101 – an overview program covering the basics of radiology business as defined under the RBMA Common Body of Knowledge.

DataMAXX

DataMAXX

RBMA’s innovative new practice analytic solution that takes benchmarking to new levels through the combination of your practice’s information and state-of-the art technology and data query protocols.

 

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Welcome, Coders!

As a coder, you have come to the right place for for information and resources that will assist you in coding properly and obtaining the best possible reimbursement for your practice.

RBMA connects coders with resources and practical tools to help you succeed.

“RBMA membership offerings, either the list serve or conference attendance, has provided up to date trends in coding, payor policy and practice management issues. The topics discussed through the list serve either coding or practice management has helped my practice be proactive.”

More Resources For Practice Coders:

Resources For Coders

Ladies

Prepare for tomorrow. Order your ICD-10-CM Toolkit today.
The IDC-10-CM Toolkit designed by Coding Strategies (CSI) and Radiology Business Management Association (RBMA) gives the busy radiology administrator all of the tools needed to prepare the practice for the implementation of ICD-10.

Libman Education
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Welcome, Marketers!

As a marketer, you have come to the right place for information on the state of imaging today and how to effectively market your radiology practice by incorporating tools and strategies including social media and today’s technological innovations.

RBMA is the place to turn for inspiration, resources and practical tools you can’t find anywhere else.

“The RBMA Marketing Conference is a great way to network with colleagues from around the country to gain different ideas and perspectives without the threat of direct competition.”

More Resources For Practice Marketers:

Order your Marketing Toolkit today.

A toolkit designed specifically for radiology marketing, includes samples forms and ideas.

Click here to preview Table of Contents.

Resources For Marketers

5 Steps to Effective Social Media Measurement
If you’re going to invest time in social media, you need to measure performance, but it can be difficult to identify relevant metrics.

How to Generate Compelling Content Ideas for Your Online Customer or Member Community [Infographic]
Are you looking for content to fulfill your new content marketing strategy, but don’t know where to start? Try these 10 great content ideas – plus a bonus idea – to jump start or breathe new life into your efforts.

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Welcome, Vendors!

As a vendor offering radiology products and services you have come to the right place to find your target audience. RBMA attracts decision-makers with buying power.

RBMA members rely on vendors to keep them informed of new technologies, developments, and products for their practices.

“RBMA provides the foundation for connecting with the right people. We appreciate the opportunity to visit with our existing clients as well as meet new prospective clients.”

More Resources For Practice Vendors:

Resources For Vendors

Start planning your 2017 marketing program with RBMA today! Consider a Global Level Sponsorship. Contact daphne.gawronhski@rbma.org for details.

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Enhance your RBMA presence, increase brand awareness, and solidify your position in the industry through a variety of sponsorship programs

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FDA Simplifies Training Requirements for DBT

(Vendor) Permanent link

For facilities that provide mammography, ensuring staff is trained in accordance with the requirements of the Mammography Quality Standards Act is an important concern. On Feb. 6, 2017, the U.S. Food and Drug Administration updated its information on training requirements for digital breast tomosynthesis (DBT) to no longer require that the training must come from the manufacturer of the device being used.

The FDA has approved DBT devices from four different manufacturers for sale in the United States. In order of manufacturer name, they are the Fujifilm ASPIRE Cristalle, the GE SenoClaire, the Hologic Selenia Dimensions and the Siemens Mammomat Inspiration. Each has its own approved indications for use and unique technologies. However, they are similar enough that the FDA believes it is appropriate to handle them as a single modality under the MQSA, just as it does for full-field digital mammography units.

What this means is that mammography providers no longer have to ensure that the eight hours of required training on the DBT device being used come from the manufacturer of that device. It can instead be provided by a third-party training course or by a “qualified peer” who has already met his or her training requirements.

One reason this change is important is that DBT is growing in popularity, especially in the U.S. market. According to Future Market Insights, an international research and consulting firm with headquarters in London, the DBT equipment market will expand at a compound annual growth rate (CAGR) of 13.9 percent over the next decade with the majority of that growth occurring in the United States.

Insurance coverage for DBT is also increasing. Five states are currently considering passing laws that would require insurers to cover DBT. They are Maryland, New Hampshire, New Jersey, New York and Texas.

For health care organizations providing DBT, knowing that a doctor or technologist trained on one DBT device can move to working with another brand of DBT equipment without additional training will certainly be a help. Although the FDA still encourages equipment operators to go through voluntary continuing education to learn the differences between devices from competing manufacturers, this is not a requirement.

To learn more about the updated FDA guidance on training requirements for operators of DBT equipment, see the FDA’s revised Frequently Asked Questions about DBT and MQSA Training Requirements. To connect with a DBT vendor, see the RBMA’s Call a Vendor online resource. 

Do Marketers Have a Role in Reducing Health Disparities

(Marketing) Permanent link

Differences between groups of Americans in access to quality health care and related better or worse health outcomes is an ongoing national problem. Since 2011, the Centers for Disease Control and Prevention (CDC) and its partners have been working to identify and address the factors that lead to health disparities among racial, ethnic, geographic, socioeconomic and other groups.

Poverty and lack of health care coverage are at the root of many health disparities, but culture is also a factor. And if anyone knows how to change culture and create new behaviors, it is marketers.

Health disparities in radiology are perhaps best seen in mammography. This important screening test has been closely studied and there is data going back decades on mammography utilization rates by ethnic background. CDC data show that in every year since 1987, white women 40 and older have gotten screened at the highest rate and non-white Hispanic women 40 and older have gotten screened at the lowest rate. Although this disparity in screening rates has narrowed over time, it still exists even as the gap in mammography screening rates between white and black women has largely disappeared.

Could marketers for mammography be doing more to reach out to Hispanic patients and help erase this disparity? Yes, say experts interviewed by the American Marketing Association in last year’s AMA Marketing Health Services: Spring/Summer 2016 report. Interviewees in the article “Is Marketing Perpetuating Latino Health Care Disparities?” make the following points on how health care marketers could reevaluate their campaigns and make changes to how they connect with potential new Latino patients.

  • Know your target audience. Although the majority of Hispanics living in the United States have cultural roots in Mexico, more than a third come from other Latin American nations. In a 2013 report from Pew Research Center, Pew identifies 14 different statistical profiles for Hispanics living in the United States. They also differ by whether they were born in the U.S. or immigrated (65 percent are U.S. born) and by generation (Millennial, Gen X or Boomer). There is a tendency to look at Latinos in aggregate and this is a mistake, said Jake Beniflah, executive director for the Center for Multicultural Science, in the AMA story.
  • Form relationships. A reason Hispanics sometimes underutilize U.S. healthcare services is that it is less relationship-based. Bridge the gap and build trust by showing up either in person or with advertising at Hispanic community functions and other events where you can become known to the local Hispanic community.
  • Embrace digital. While Spanish-language, printed materials are important, don’t stop there. Latinos are adopting mobile phones faster than any other demographic, according to a Nielsen study. “The internet has made a major advance as a trusted source of medical information for Hispanics,” said Beatriz Mallory vice president of SensisHealth, a multicultural health care marketing agency. 

Finally, while there is an undeniable ethical imperative to care about health disparities if one values equality in health care, there is also a business imperative for marketers. The Latino population is projected to reach 119 million (or nearly 29 percent of the U.S. population) by 2060. If Latino women 40 and older are not being screened for breast cancer at the same rate as other groups, that gap represents mammography business your facility could be missing out on. 

Coding Focus Returns to RBMA Conferences with PaRADigm

(Coding) Permanent link

Among the RBMA’s nine online forums, the coding forum is consistently the most active. Members regularly turn to the coding forum for advice on how to bill unusual cases or respond to certain payor denials. Frequently, the forum is the first place to learn about mistakes or wrong interpretations by the Centers for Medicare and Medicaid Services and their administrative agents.

Now coding is returning as a focus area to the RBMA conferences with PaRADigm is the RBMA’s new single annual conference for all members. Premiering April 23 to 27 in Chicago, PaRADigm expands the conference coding and billing educational options with sessions suitable for both experienced coders and those learning the field.

“This is a big deal,” says James Hamilton, RBMA Board of Directors president and administrator and business manager for Medical Imaging Physicians, Inc., in Dayton Ohio.

On Monday, April 24, the first full day of PaRADigm, Walt Blackham, RCC, senior vice president of Coding & Client Services for MSN Healthcare Solutions as well as a former RBMA Coding Committee Chair with decades of experience in group practice management and coding, will present on 2017 Coding Updates. The session is suitable for all experience levels, Blackham says.

In addition, Karna Morrow, a senior consultant at Coding Strategies, Inc., in Atlanta will present on the basics of interventional radiology coding, and Stephanie Dybul, division administrator for vascular and interventional radiology at The Medical College of Wisconsin in Milwaukee, will cover how to code for evaluation and management (E&M) services related to radiology.

On the last day of the conference, Advocate coding documentation and education managers Jennifer Bash and Debby Mann will team up for a presentation on how to get clinicians on the same page with coders when it comes to clinical vs. coding documentation requirements.

There will also be a billing services roundtable discussion and much more. To view the full RBMA PaRADigm conference schedule, click here. To learn more about the RBMA’s online forums and subscribe (a member only benefit), click here


How Management Heroes May Harm their Group

(Management) Permanent link

Radiology practice managers are in the business of making a group function as optimally as possible. The excellent ones know how to work with the group’s various partners and manage their eccentricities. They are masters of human nature and know how to minimize conflicts among the group’s partners over decisions and keep different personalities with strong points of view from clashing in a way that hurts the overall prospects of the group.

However, when making everyone get along covers up a problem in the group’s makeup or management structure that needs to be dealt with by the partners, the desire to help can actually harm says Will Latham, founder of Latham Consulting in Charlotte, N.C.

As a consultant, Latham has worked with many groups that are in trouble, and he spends a lot of time thinking about why groups become dysfunctional in the first place. One big issue, he says, is that physicians are typically conflict avoiders who want the best of group practice and the best of sole practice at the same time. They will go along with decisions they like and simply ignore decisions they dislike rather than speaking up or working to get those decisions changed.

Managers can’t really change this, but if the practice partners are ignoring each other’s decisions, then managers need to think carefully about how much they should be doing to help paper over fissures and keep things running smoothly.

“Managers are not in a position to be bossing anybody around, but what they can do is torture the group into creating some structure, so that the group can deal with these issues,” Latham says.

Torturing the group to Latham means reminding them that disruptive physician behavior doesn’t just impact one person, it impacts the whole group. Frequently, he will hear from members of groups where there is a disruptive physician that they have thought about leaving the group because of the group’s failure to deal with the issue.

“The problem with disruptive physicians is that those people do stuff and get away with it and it demoralized the 90 percent of people in the group who are doing the right thing,” Latham says.

Managers can’t force a group to take action, but they can make sure the leadership understands that leaving the issue aside for another day to avoid confrontation has consequences. 


Seeing the World Through Your Patients’ Eyes

(Leadership) Permanent link

As radiology practice leaders, the world of imaging is familiar. The sights, the smells, the sounds and even the noise of an MRI can be comforting in their ordinariness. The view from the patient’s perspective is quite different.

In a 2015 study, radiologists from Langone Medical Center in New York interviewed their patients and found that even very “experienced” patients who had undergone multiple imaging studies were unknowledgeable about how imaging procedures worked. Only 35 percent of the patients in the study thought CT scans used ionizing radiation. In addition, 29 percent wrongly believed that MRIs used radiation. Two out of five patients thought sterility was a risk from imaging and one in five thought acute radiation sickness was a risk.

And as confusing as the actual procedure may be, the business side of radiology is even more of a black box to patients.

“Few healthcare consumers know how to navigate the revenue cycle,” writes T. Scott Law, founder and CEO of Zotec Partners, in the November/December issue of the RBMA Bulletin. “Instead, many expect radiology practices to provide a seamless billing experience on par with other industries.”

The issue with patients not understanding either the clinical side or the business side of medical imaging is that it leads to frequent misunderstandings that can upset and frustrate patients. They don’t understand why they cannot learn the results of their exam at the time they are imaged nor why it is difficult to give them an up-front estimate of their costs for the exam. But there are things that can be done to improve patient understanding and avoid subsequent misunderstanding that lead to poor customer experiences.

Scott writes that radiology group leaders should not turn a blind eye to technology other industries have already adopted to make it easier for patients to understand their bills, set up payment plans and make payments in the format they prefer, including online.

“Revenue cycle is really the only exposure radiology patients have in healthcare to someone who is not related to treatment or care, and therefore, it’s a very important job,” he writes.

On the clinical side, leaders need to commit to prompt delivery of radiology reports and implement technology and service that will help patients communicate with imaging specialists even if this creates occasional problems, writes Murray Reicher, M.D., FACR, chief medical officer of Merge Healthcare, in the same issue of the RBMA Bulletin.

“These logical and simple suggestions can help build a practice and a culture of health information transparency, thus raising the health literacy of our communities as well as overall patient satisfaction,” Dr. Reicher wrote.

Vendors Consider How to Approach Hacking Threat in Radiology

(Vendor) Permanent link

Political hacking and cyberwarfare is an ongoing threat, but it is not the only kind. Medical device manufacturers continue to be concerned about the threat of hacking as more and more devices are connected to the internet. Radiology has been a leader in the adoption of the “internet of things,” yet even in this field, the focus has been more on the many benefits derived from connecting systems through the internet and less on the potential dangers posed if devices that communicate with outside systems through the internet are hacked.

At an RSNA 2016 scientific session, researchers from Massachusetts General Hospital presented alarming results from a study of DICOM servers. The researchers used a program to search for DICOM servers worldwide that were unprotected. They found 2,782 unprotected DICOMM servers with 821 of those servers being fully open to outside communication.

What’s worse, in the study, the United States lead the world in number of unprotected servers with 1,150 unprotected DICOM servers. Russia, by comparison, only had 22. Of these, around 300 U.S. DICOM servers could be taken down by a hacker at any time because they were fully open to communication.

While some of the responsibility for the security of medical devices rests with the purchasers of those devices, increasingly equipment manufacturers, installers and servicers recognize that they need to be the leaders here as purchasers (aka, healthcare providers) are rarely in a position to fully understand how advanced devices can be hacked and what they can do to protect them.

In November, the Global Diagnostic Imaging, Healthcare IT & Radiation Therapy Trade Association (DITTA) issued a white paper on cybersecurity of medical imaging equipment. Available through the Medical Imaging Technology Association, the white paper covers many key points, including the following:

  • A critical component of cybersecurity is carrying out security-risk mitigation while the software is developed.
  • Manufacturers should not assume that a secure system today will remain secure tomorrow as hackers are always working on new ways to breach systems. Therefore, manufacturers can and should better define how they plan to continually monitor for security problems that may develop later in the system’s lifecycle and issue fixes and upgrades.
  • Manufacturers and their field service representatives can help educate equipment users on best practices. For example, security whitepapers, issued by manufacturers, are good teaching tools for operators and can help them take steps to reduce hacking risk.
  • When installing a device, suppliers should close unused ports, interfaces and other communication channels on devices. In addition, testing how vulnerable a device is to hacking in the real-world situation it will be used in is important.
Users sometimes hesitate to perform virus scans or install security upgrades because of issues with false positives (saying a device is infected when it is not) and past experiences with upgrades that negatively impacted a device’s functionality. It is important that all upgrades be fully analysed and validated before they are released because once a user has had a bad experience with an upgrade, that user will be less likely to perform upgrades as scheduled in the future.

When it Comes to Stark Law, Good Intentions Don’t Matter

(Marketing) Permanent link

One of the biggest mistakes radiology practice marketers make when it comes to adhering to the requirements of the Stark Law, which prohibits Medicare and Medicaid patient referrals to entities that the referring physician has a financial relationship with, is believing that intentions matter, says Adrienne Dresevic, Esq., founding partner of the Southfied, Mich., firm The Health Law Partners, P.C.

Dresevic and Clinton Mikel, Esq., another partner in the firm, are experts on the many technical requirements of the laws that govern relationships between provider entities and referring physicians. They advise radiology and other specialty groups and have found that while few marketers ever set out to intentionally violate the law, this is of no help when a mistake is made.  

“Stark is a strict liability law so intent doesn’t matter,” Dresevic says. “The law is technical in nature so you can have the best intentions in the world and it really doesn’t matter. All the claims submitted connected with [the violation] are tainted.”

For example, a hypothetical practice might want to help patients who are struggling to cover their co-pays. The practice tells their referring physicians that they are waiving co-pays for Medicare and Medicaid patients. While nice, this is a violation of the law as it would create an incentive for those physician to refer all of their Medicare and Medicaid patients to that practice.

Another common mistake is thinking the law does not apply because there is no financial relationship, but a financial relationship can be triggered by even a small gift, like buying lunch for the physician’s office, if rules are not followed closely, Dresevic says.

Likewise, Independent Diagnostic Testing Facilities that provide mobile imaging services also may think the law does not apply to them because they are not a hospital or physician group, but it does, Mikel says.

Dresevic and Mikel will be presenting on the requirements of the Stark Laws and the Sunshine (Open Payments) Law at the Building Better Radiology Marketing Programs conference in Fort Worth, Texas, on Monday, March 6. Their session will be in a question and answer format and based on a webinar that RBMA members will have the opportunity to watch online ahead of the conference.

Being able to list the key elements of the Stark and Sunshine laws is something everyone on a marketing team needs to be able to do, Mikel says. Although marketers themselves will not be financially penalized by the government if the laws are violated, they need to understand the details of the legal requirements and not leave adherence to the laws up to others in the practice.

“Stark, the Sunshine Act and some of the tracking you need to do for the technical requirements are fairly granular and the persons theoretically overseeing the practice are not the ones doing the day-to-day work,” Mikel says. “They are not doing the day-to-day allocations of how much was spent toward marketing to a particular physician group. These are technical laws and yes the entity will get in trouble if the marketer does not comply with the law, but it is important for the marketer’s job to understand the parameters of dos and don’ts so it doesn’t reach that point of a payment refund.”

In addition, while marketers themselves may not be financially at risk for violating Stark and Sunshine laws, the government can use its exclusion authority to get at a marketer who violates the laws.

To become better at navigating the many legal requirements for marketers in a highly-regulated field like radiology, attend the Building Better Radiology Marketing Programs conference. A special early-bird discount is available until February 3. 


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