Insurer wins radiology reimbursement battle over 'double billing'

Blue Cross and Blue Shield of North Carolina (BCBSNC) has won a reimbursement dispute with physicians--represented by the North Carolina Medical Society and the North Carolina Hospital Association--in which BCBSNC argued that radiology practices were charging double for services provided only once, the Triangle Business Journal reports.

Blue Cross argued that radiology practices were "double-billing" in cases where a radiologist took multiple images during a single appointment. While patients would go through various pre- and post-procedure activities such as check-in, room preparation or gown, only once, BCBSNC was charged for those services per image.

The providers argued that that's how contracts had been negotiated and said they should be honored as such. A ruling by the North Carolina Department of Insurance, however, determined that insurers could alter some reimbursement policies without negotiating with providers. Article

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