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Imaging Accreditation Protocol - Chapter 13, 2018 UnitedHealthcare Administrative Guide

This Imaging Accreditation Protocol promotes compliance with nationally recognized quality and safety standards. If you perform outpatient imaging studies and bill on a CMS 1500, or the electronic equivalent, you must get accreditation from one of the accrediting agencies listed on > Prior Authorization and Notification Resources > Radiology.

The accreditation process takes six to nine months to complete. Once we notify you, failure to obtain accreditation affects your right to be reimbursed for these procedures. We may do an administrative claim reimbursement reduction for global and technical service claims.

To avoid a decrease in payment, we require accreditation for:

  • CT scan
  • MRI
  • Nuclear medicine/cardiology
  • PET scan
  • Echocardiography

This applies to global and technical service claims.

You can apply for accreditation by submitting an application and fulfilling accreditation standards.

More details about imaging accreditation are available on > Imaging Accreditation.