WMI will negotiate either capitated or discounted fee-for-service contracts for all diagnostic imaging services. Flexibility is our hallmark. As such, we are open to the possibility of starting with a discounted fee-for-service arrangement and moving to capitation as our experience with a particular payor becomes better defined.

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2.   How will WMI bill its contracted payors?

For discounted fee-for-service contracts, all WMI member groups will bill for services rendered to your patients according to the terms negotiated by WMI. The reimbursement accepted for each type of exam will be the same at all WMI facilities. For capitated contracts, all administrative services will occur at the WMI corporate office, and all WMI member groups will agree to be part of that contractual arrangement.

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3.   Does WMI have plans for expansion?

Currently, WMI has 11 member groups totaling approximately 190 board-certified radiologists in most major population centers in Washington. Our network has been fairly stable since December 1994, but we are often approached by additional radiology groups inquiring about membership in our network. If additional geographic areas are required by payors, we will contract with the highest quality diagnostic imaging providers in that area as quickly as possible.

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4.   What systems are in place to achieve comprehensive, consistent quality?

WMI physicians developed a single, uniform set of quality standards for credentialing our physicians and equipment based on national and community standards. We have developed a centralized database to monitor utilization rates for all exams and, in conjunction with outcome measures, to determine the most cost-effective service utilization. Uniform imaging criteria developed by WMI and approved by referring physicians in Washington are distributed as guidelines for determining the most cost-effective studies needed for patient care. Retrospective analyses and education of referring physicians and radiologists are used to monitor all exams.  Uniform quality improvement standards are utilized network-wide.

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5.   How will you let us know about changes in your organization or members?

WMI will regularly publish information detailing locations where patients can receive services within our network. This, and other salient information about WMI can be regularly viewed on-line on this Internet web site.

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6.   What kinds of reports will we receive?

WMI will work with payors to produce customized reports in a form that is most useful to you. Typical reports will detail the volume and location of services used, and which physician ordered the imaging exams. This information can be used in conjunction with other plan data to help educate referring physicians about their overall utilization patterns. WMI also will look at the results of our radiologists' interpretations to evaluate the consistency of their work. In addition, these quality criteria are applied to the referrals received by WMI member groups. In this way, our customers are actually provided with an objective quality measurement of the referrals made by their panel of physicians. As such, our utilization management system provides one of the first (and most useful) forms of quality measurement in healthcare today.

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7.   What about emergency care outside of WMI members' areas?

WMI has the ability and flexibility to either include or exclude out-of-area claims in our contracts, depending on the needs of the payor. If a contract includes out-of-area services, WMI will sub-contract with primary care physicians, hospitals and/or other specialists to provide needed services to patients. If a payor decides to exclude a particular group of diagnostic imaging exams, WMI has the flexibility and experience to negotiate a mutually acceptable contractual management.

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8.   How much experience does WMI have in managed care?

Each WMI member group is managed by a capable administrator, many of whom have significant managed care experience. Most importantly, all WMI physicians have a strong belief that the clinical management of diagnostic imaging services actually enhances the quality of care delivered to our patients, through the provision of the most appropriate imaging services to patients as quickly as possible.

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