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Blue Cross Blue Shield of Michigan (BCBSM) Physician Group Incentive Program (PGIP) |
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Radiology Management Initiative Radiology High Tech Utilization
Goal · Reduce the utilization PMPM for radiology procedures; · Increase compliance with prior authorization through AIM for high tech procedures; · Increase the use of the web-based authorization tool; and · Lower the overall radiology cost PMPM.
Objective · Increased compliance with the use of AIM pre-authorization process and the use of AIM website (the web use rate > 50%). At year end 2009, JPA compliance was at 90.1% and website use was at 58%. JPA’s standard cost PMPM to be at or below the established benchmark. JPA’s standard cost PMPM for 2009 was $18.17. The benchmark range was $15.33—$20.28. Practices should 1. Be sure to comply with AIM pre-authorization and use the AIM website for high cost radiology procedures; and 2. Monitor your practice’s cost PMPM reported by JPA discussing ways that this cost could be decreased.
Resources · Radiology Authorization Procedures
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Service Focused Initiative |