Julie Irons, Accreditation Manager
Many advance diagnostic imaging (ADI) providers dread the accreditation mandate pursuant to the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA). This requires the ADI provider to submit an accreditation application with documentation, along with clinical studies and phantom images, every three years to stay accredited. Without an accreditation seal from RadSite or one of the other CMS-recognized accreditation organizations, an ADI provider will not get reimbursed by the federal government for the diagnostic imaging services rendered to a Medicare beneficiary. Many private payers accept RadSite accreditation for their providers.
Through the MIPPA Accreditation Program (MAP), RadSite has done its best to create a meaningful accreditation review process but one that also is efficient. As part of the accreditation application process through RadSite’s online accreditation portal, a number of documents are required to be uploaded as part of the desktop review. This blog post highlights several of those key documentation requirements.
Applicants must submit several types of documents for review covering professional qualifications, professional oversight requirements, and designated written policies. The RadSite MAP Standards provide a detailed explanation of what is required, and RadSite account managers are on standby to provide applicants with additional information and can answer any questions.
Professional Qualifications
Documents to be submitted in this section consist of your credentialing policy, personnel’s licensure, board certifications, CE credits, and liability insurance certificates. All of the essential personnel you employ should be able to provide the appropriate validation to satisfy your credentialing requirements. All personnel should be vetted through primary and secondary sources upon hire and at least once a year afterwards. If the position is contracted, we require a copy of the contract or the HIPAA BA agreement.
Professional Oversight
Documents to be submitted in this section cover oversight or duties and responsibilities. RadSite needs to know three important things about an ADI provider’s key personnel: what their responsibilities are; what their job requirements are (i.e., education, licensure, and certification); and what their reporting structure is. Key clinical staff may hold multiple positions but each position requires its own, separate job description. Reviewing job descriptions as part of the yearly credentialing process is a good rule of thumb.
Policies and Procedures
RadSite also requires a sample of the applicant’s written policies and procedures (P&Ps), which is detailed in the MAP Standards. All policies should contain basic information, name of the policy, date the policy was created, and when it was last reviewed/revised, purpose and, of course, the actual policies and procedures.
Many small radiology offices don’t have written P&Ps. But keeping a written description of what you do in a formal binder is best practice and will only make your office work more effectively. It also is a MAP requirement. The policy binder should have a master index listing all of the policies, the review/revised dates, and should be signed off by both the medical director and the imaging/office manager. The key is to document your processes and review them on a yearly basis.
Final Thoughts
RadSite’s goal is to make sure we are sharing best practices with applicants and vice-versa. The goal is to empower ADI providers to optimize imaging practices in way that promotes quality and efficiency. Proper documentation is a good start in terms of promoting consistent practices. Accreditation does not have to be a chore—especially if the provider is proactively and regularly updating its key P&Ps and related documents that support its imaging practice.
In future blog posts, we will talk more about the accreditation process, including the submission requirements for clinical images and phantom studies. To learn more about RadSite’s accreditation process, also check out our past webinars.