Externally Acquired Radiological Data for the Clinical Routine – A Review of the Reimbursement Situation in Germany

Abstract

Background Interdisciplinary radiological conferences and boards can improve therapeutic pathways. Because of the reinterpretation and presentation of external image data, which already was read, an additional workload is created which is currently not considered by health care providers. In this review we discuss the ongoing basics and possibilities in health economy for a radiological second opinion for the outpatient and inpatient sector in Germany.

Method Based on up-to-date literature and jurisdiction, we discuss the most important questions for the reimbursement for second opinions and conference presentations of external image data in an FAQ format. Additionally, we focus on the recently introduced E-Health law accordingly.

Results Radiological services considering second opinion or board presentation of externally acquired image data are currently not adequately covered by health care providers. In particular, there is no reimbursement possibility for the inpatient sector. Only patients with private insurance or privately paid second opinions can be charged when these patients visit the radiologist directly.

Conclusion Currently there is no adequate reimbursement possibility for a radiological second opinion or image demonstrations in clinical conferences. It will be essential to integrate adequate reimbursement by health care providers in the near future because of the importance of radiology as an essential diagnostic and therapeutic medical partner.

Key Points: 

• Currently there is no reimbursement for image interpretation and presentation in boards.

• Second opinions can only be reimbursed for patients with private insurance or privately recompensed.

• The E-Health law allows reimbursement for tele-counsel in very complex situations.

• It will be crucial to integrate radiological second opinion in future reimbursement policies by health care providers.

Citation Format

• Schreyer AG, Steinhäuser RT, Rosenberg B. Externally Acquired Radiological Data for the Clinical Routine – A Review of the Reimbursement Situation in Germany. Fortschr Röntgenstr 2018; 190: 427 – 432

Key words

reimbursement - medicolegal Issues - second opinion

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