Anthem Blue Cross Blue Shield (Connecticut)
Unveils Program To Help Ensure High-Quality Imaging Services
from
the December 2005 issue
In
an August 22, 2005 letter to all providers, Anthem Blue Cross
Blue Shield (Connecticut) announced its adoption of Diagnostic
Imaging Services Quality and Network Management Criteria
for its participating providers who offer diagnostic imaging
services to Anthem BCBS members. As detailed below, guidelines
now exist related to three of the accrediting bodies within
the Intersocietal Accreditation Commission: the ICAEL, the ICAVL,
and the ICANL.
As
stated by Anthem BCBS, "The Diagnostic Imaging Services
and Network Management Criteria were developed to promote
reasonable and consistent standards for the performance of diagnostic
imaging services for Anthem members and have been approved by
Anthem's Medical Management."
Anthem
BCBS is utilizing National Imaging Associates, Inc. (NIA), a
national radiology management company, to help implement the
program.
Guidelines Specific
To Echocardiography
- Echocardiography
providers must be board certified in diagnostic radiology
or cardiology.
- Echocardiography
systems must have color flow Doppler capability.
- Echocardiography
practices must achieve accreditation by the ICAEL (Intersocietal
Commission for the Accreditation of Echocardiography Laboratories)
by November 1, 2007. [NOTE: Practice must submit evidence
of application for accreditation to NIA by February 1, 2006,
and refers to laboratories ordering the accreditation materials
by 2/1/2006.]
Guidelines Specific To Nuclear Cardiology
- Nuclear
cardiology practices must employ at least one physician who
is board certified in diagnostic radiology, nuclear medicine
or has received certification by the Certification Board of
Nuclear Cardiology (CBNC).
- Nuclear
cardiology practices that do not meet the above criteria will
be considered for participation upon submitting evidence that
at least one physician has satisfied the Level II training
in Nuclear Cardiology as recommended in the American College
of Cardiology / American Society of Nuclear Cardiology, Core
Cardiology Training Symposium (COCATS) Training Guidelines.
- Nuclear
cardiology practices must use a technologist who is certified
in Nuclear Medicine through the ARRT, CNMT, or NMTCB, or licensed
by the state in nuclear medicine technology.
- Nuclear
cardiology imaging systems must have the capability of assessing
both myocardial perfusion and contractile function (ejection
fraction and regional wall motion).
- Cardiac
stress tests must be performed under the direct supervision
of a board certified cardiologist or a licensed physician
who has a current Advanced Cardiac Life Support (ACLS) or
Advanced Radiology Life Support (ARLS) certification.
- Nuclear
cardiology practices must provide a copy of the Radioactive
Materials License that indicates the practice address and
name of the nuclear cardiology physician(s) performing and/or
interpreting nuclear cardiology studies. The address and physician
name(s) must be the same as those listed on the Application
completed by the practice.
- Nuclear
cardiology practices must achieve accreditation by the ICANL
(Intersocietal Commission for the Accreditation of Nuclear
Medicine Laboratories) or the ACR (American College of Radiology)
by November 1, 2007. [NOTE: Practice must submit evidence
of application for accreditation to NIA by February 1, 2006,
and refers to laboratories ordering the accreditation materials
by 2/1/2006.]
Guidelines
Specific To Peripheral Vascular (PV) Ultrasound
- PV
Ultrasound providers must be board certified in diagnostic
radiology, vascular surgery, cardiology or neurology.
- PV
Ultrasound providers must employ a sonographer certified by
the ARDMS or ARRT.
- PV
Ultrasound systems must have color flow Doppler capability.
- PV
Ultrasound providers must achieve accreditation by the ICAVL
(Intersocietal Commission for the Accreditation of Vascular
Laboratories) or the ACR (American College of Radiology) by
November 1, 2007. [NOTE: Practice must submit evidence
of application for accreditation to NIA by February 1, 2006,
and refers to laboratories ordering the accreditation materials
by 2/1/2006.]
The
Anthem BCBS Diagnostic Imaging Services Quality and Network
Management Criteria also include requirements for Bone Densitometry;
Obstetrical/Gynecological Ultrasound; Urological Ultrasound/Imaging;
Mammography; Positron Emission Tomography (PET); and free-standing
imaging centers providing CT and/or MR. Diagnostic imaging providers
with questions about any of the above guidelines should contact
the National Imaging Associates (NIA) Quality Assessment Department
at 888-972-9642 or their Anthem Provider Relations representative.
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