Page 8 - 2022 Risk Basics - Radiology

SVMIC Risk Basics: Radiology

A total of 6,526 claims (which included lawsuits and/or demands for

payment where no lawsuit was filed) were closed between 2006 and
2015. Of these, 28 percent resulted in an average indemnity payment of

$364,106 which was the sixth highest average indemnity payment among
all of the healthcare specialties.

The largest payment reported for a radiology claim was $3.3 million. For

reference, the largest OB/GYN surgery payment reported was $13 million.

The paid-to-closed ratio was higher for radiology claims (28 percent)

than all other healthcare specialties combined (27 percent). This means
there was a greater likelihood that a claim would be paid to close it than

with all other specialties combined.

An encouraging statistic revealed by the study was that when comparing
the two five-year intervals, 2006-2010 and 2011-2015 (in real 2015 dollars

for radiology claims), the average indemnity payment decreased by 9
percent. However, comparing radiology to all the healthcare specialties

combined for the most recent period (2011-2015), the average indemnity
payment (again, in 2015 dollars) was 7 percent higher.

Focusing solely on the most recent five-year period in which the data
was analyzed (2011-2015), the study revealed the following:

• Neoplasms of the breast, unknown if malignant or benign, was the
most prevalent presenting medical condition for radiology claims.

• Screening for malignant neoplasms was the most expensive
presenting medical condition for radiology claims.

• Five percent of radiology claims noted neoplasms of the breast,
unknown if malignant or benign, as the most prevalent presenting

medical condition, resulting in an average indemnity payment of
$448,929.

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