Ah! I understand what you mean. I worked in a hospital as physician billing manager. The hospital had an agreement that all radiology billing was to come out of radiology. The E/D was not permitted to bill for any xray readings - the subcontracted radiology dept did the billing (using modifier -26) and the hospital itself billed for the technical component. We even had an out of state radiology group that would take on reading xrays from midnight to 8am, and the radiology docs would re-read the xrays in the morning, prepare the reports and do the billing.
So, even though radiology did not order the xrays (the ED docs did), the subcontracted radiology group performed the xray, read the xray, generated a report, and filed the claim to the insurer.
By the way, our E/D chief disliked the setup because the E/D had a tendency to run at a loss (much to the dismay of the hospital president!).
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