Managed Care and Private Payer Issues

Resources to help ACR members deal effectively with managed care organizations. We evaluate trends in payer behavior and philosophy and educate payers, patients and hospitals about the value of diagnostic and therapeutic radiology in providing cost-effective medical care.

We are dedicated to working with private payers to achieve appropriate reimbursement for radiology and radiation oncology and to providing guidance on common coverage issues.


Anthem Outpatient Imaging Policy Resources

Regardless of whether you practice in an office setting or hospital, ACR urges you to oppose a new Anthem Blue Cross Blue Shield outpatient imaging policy which makes imaging a commodity to be performed by the lowest bidder.
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Developing a Radiology Advisory Committee

Get suggestions on how to develop a Radiology Advisory Committee to act as a liaison between the radiology community and payers to foster effective and valuable communication.
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Digital Breast Tomosynthesis

The ACR position on DBT is that it is no longer investigational. The College has assembled information to assist members in working with private payers to secure coverage of this important technology.
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IMRT

IMRT is not a new technology, but is a new application of an existing technology (namely, external beam radiation therapy). We have provided detailed information supporting the use of IMRT.
ACR Practice Parameter for Intensity-Modulated Radiation Therapy



ACR Managed Care Network

States A-K

States L-N

States O-W

Alabama
Thomas Loflin
John Renz
Alaska
Leonard Sisk
Arizona

Herbert Hitchon
David Lawson
Alan Wray

Arkansas

Loverd Peacock

California

Richard Fulton
William Noyes
Jinha Park
Mark Yeh

Colorado

Kathryn Howell

Connecticut

Felicia Tencza

Delaware

Michael Dzeda

District of Columbia

Raymond Tu

Florida

Philip Cook
Mark Cooper
Cornelius Rater
Robert White

Georgia

Mark Bernardy
John Ravita

Hawaii

Michael Meagher

Illinois

Robert Cavallino
Najeeb Mohideen
Brian Moran

Indiana

Thomas Dugan

Iowa

Andrew Berkow
Hamed Tewfik

Kansas

Mordecai Kopperman
John Lohnes Jr.
Vickie Massey

Kentucky

Peter Locken III
James Reed

Louisiana

Alfred Mansour Jr.

Maryland

Richard Hudes
James Winthrop

Massachusetts

Steven Birnbaum
Robert McAnaw Jr.
Paul McKeough
John Patti
Philip Rogoff
Jenifer Siegelman

Michigan

Gary Gustafson
Kurt Tech

Minnesota

Sadia Choudhery
Jerry Froelich
Michael Nelson

Mississippi

Ralph Wells

Missouri

Larry Johnson
Jeffrey Thomasson

Nebraska

Patricia Helke
Robert Thompson

Nevada

Anthony Bruno
Danny Curtis

New Hampshire

Andrew Brown

New Jersey

Donald Denny Jr.
Peter Ho
Lawrence Swayne

New Mexico

Paul Anthony
Susan Edwards

New York

Raja Cheruvu
Lance Hellman
Andrew Litt
Geraldine McGinty
Clifford Phillips

North Carolina

Hal Safrit

North Dakota

Richard Marsden

Ohio

Parag Parikh

Oregon

William Marks

Pennsylvania

William Poller
Robert Pyatt Jr.
Christopher Roth

South Carolina

W Conwell
Gilbert Parker Jr.

South Dakota

John Griffin
Thomas Krafka

Tennessee

Kenneth Lloyd

Texas

Tilden Childs III
Thomas Fletcher
Joaquin Mira
Timothy Nichols
Kurt Schoppe

Utah

Dennis Welch

Vermont

Norman Sturtevant

Virginia

Stephen Chang
Peter Hulick
James Jelinek
Kathryn Keysor
Angela Kim
George Trivette

Washington

Kasra Badiozamani
Gregery Kienzle
Justin Smith

West Virginia

Paul Akers
Michael Stewart

Wisconsin

William Pao
Timothy Swan

Wyoming

Geoffrey Smith

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