HOW IT WORKS
We would like to introduce you to our business. On this page you will see our company's process and how we can best serve you.
You Decide The Frequency
We tailor the frequency of our visits to your office, to reflect the needs of the practice. In most cases, we provide ultrasound scanning services to a particular clinic one day per week. However, we have clinics that we frequent as often as three days per week or as seldom as once per month.
We can help to evaluate the need and determine the appropriate level of coverage. if your needs change, we can easily make adjustments in the schedule.
Explination of Fees
We charge the practice a flat fee for the day of service. All exams performed at the clinic are then billed by the clinic for reimbursement as an ancillary service. A typical day would have the capacity for 16 exams.
< one exam every 30 minutes >
For example, if we are there every Monday, the clinic staff at check-out would add the patient that needs an Ultrasound, Echocardiogram or Vascular Doppler to the next week's ultrasound schedule.
When we arrive on Monday morning, there is a schedule for that day already in place. Obviously, if there are time-slots open in the schedule and the physician wants to add on a patient for same day scanning, that is absolutely acceptable.
At the end of the day, the technologist will provide the clinic with preliminary technologist impressions for each patient. Also, we provide a list of the patients and exams done that day. The exams will show the appropriate CPT codes for your billing staff. We will gladly work with the staff to get them comfortable with the process before we start.
If you would like to research the Medicare Fees for various ultrasound exams use the link below:
Medicare Physician Fee Schedule
Official Report
An official report is rendered by a Radiologist or Cardiologist. We send the exams (images, technologist report, and a demographic page supplied by your office) to the reading physician. They interpret the exam and send a final report to your office by fax or email.
If you have a particular reading physician that you would rather have, we can look at setting something up with them. However, if you want to use the physicians already working with us, they will typically have a turn-around time of 48 hours from when they get the exams.
If you choose to use our physicians there may be separate charges for interpretation, outside of the agreement you have with Sound Solutions. It depends on whether the patient is covered by insurance that is from the government (i.e. Medicare) or if they have a private third-party-payer insurance (i.e. Blue Cross Blue Shield).
See more about Interpretation Fees below
Interpretation Fees
Obviously, the reading physician deserves to be paid for their services, but how they receive their compensation is the question at hand. It depends on the patient's insurance carrier.
For Example:
-
Private Insurance
The clinic where the scan was performed will bill the Global Fee (CPT code without modifier) and will receive an invoice from the reading physician for the interpretive services. The Global Fee is essentially a combination of the Technical Fee (portion for the clinic) and the Professional Fee (portion for the interpreter).
Since the clinic is being reimbursed for both in a Global Fee, the Professional portion is passed on to the interpreter. The reading physicians working with Sound Solutions have made it simple in these cases to only require:
-
A Flat fee of interpreter services:
-
Echocardiogram - $60.00
-
All Other Ultrasounds - $30.00
-
This amount could change in the future to reflect changes in reimbursement allowed by Medicare, but has held steady for many years
-
Medicare Insurance
This arrangement is not as complex as private insurance.
The clinic simply bills the insurance
for the Technical Component
(modifier - TC)
AND
The reading physician bills the insurance
for the Professional Component
(modifier - 26)
No invoice for this report would be received by the clinic from the interpreter
-
Hybrid Insurances
There are however, some insurances that are harder to define because they are essentially a combination or a hybrid type.
For Example: Viva Medicare Plus or Blue Advantage
We have found it best to treat all these as Medicare Insurance and file for reimbursement in that fashion.
