Your CT scanner runs all night. Your radiologist does not.
Community and critical access hospitals image around the clock and staff radiology for part of it. This page is for the administrator holding that gap: what it costs the department now, what you would send us, how your medical staff office gets our readers privileged, and what actually reaches the chart.
Each of those four is defined and dated on the SLA and quality page, and repeated with a citable anchor per figure on the facts page.
The gap is in the call schedule, not in the scanner.
None of these is a volume problem. All three are schedule problems, which is why hiring is the slow answer to them.
The ED holds a bed waiting on a read
The scan is acquired, the patient is still in the department, and the interpretation waits for morning or for a phone call to someone who was asleep. Length of stay grows around a study that was already done.
Two or three radiologists cannot cover 168 hours
Every night on call is a reading day degraded, and coverage that runs on goodwill ends the week one person retires or resigns. The schedule is the risk, not the study count.
A preliminary read is a read you pay for twice
A prelim overnight means your own radiologist re-reads the study in the morning before anything is final. You bought one interpretation and received part of one.
What a hospital sends, and on which clock
Most hospitals start with nights, weekends and holidays, then add whatever the day list cannot absorb. You decide the split; nothing here requires an all-or-nothing handover.
- Head and cervical spine CT from the ED
- CT angiography and trauma imaging
- Body CT and ultrasound overnight
- Inpatient and next-day plain film
- MRI, including inpatient MRI
- Nuclear medicine and PET-CT
Your medical staff office, and the credentialing path
This is the step that decides whether you go live in two weeks or two quarters, so it is worth walking before you sign anything.
Credentialing by proxy, where your bylaws allow it
A hospital may credential and privilege distant-site telemedicine physicians in reliance on the distant-site entity when the written agreement and the medical staff bylaws provide for it. Where that path is open to you it removes most of the packet work from your office. Where it is not, we run the full application per reader.
What your medical staff office receives
Per reader: state licence, board certification, individual NPI, certificate of professional liability insurance, current privileging profile and query results, in the format your office asks for rather than ours. Credential files for every reader are available during procurement, before you commit.
A named panel, not an anonymous pool
You are credentialing a defined group of radiologists, and you can see who they are. Studies route by modality and body part to a subspecialist credentialed for that work, so the neuro study reaches a neuroradiologist rather than whoever is next in a queue.
A final report, before the patient leaves the department.
Your ED physicians and hospitalists act on what arrives, and a report they cannot act on without a second opinion has not solved the coverage problem.
A final read your morning list does not have to repeat
The interpretation is final and signed. It does not need an in-house overread before the study can be closed, which is the difference between buying one read and buying part of one.
A named signer your medical staff office has already credentialed
The reading radiologist's name, credentials and state licence are on the report, frozen at signature time. There is no anonymous pool signature and no group byline standing in for a person.
Delivered into the PACS and EMR your ED already works in
Signed reports return to your PACS and into your RIS and EMR over the standard HL7 result interface, with a PDF copy anywhere else you want one. Nothing installs on your side and no clinician learns a new viewer.
Critical findings phoned to the treating clinician
A suspected critical finding is phoned to your team within minutes of sign-off and recorded on the report with the time and the person it was given to, so the callback is evidenced rather than remembered.
Who bills the professional component
Billing is set in your agreement rather than on this page, because it depends on how your professional billing runs today. What is true of every report either way: it is a final signed interpretation, and it carries the reading radiologist's full name, credentials and the state licence they read under, so the report is chart-ready as it arrives. Tell us how you bill now and the arrangement goes in writing before you sign anything.
Ten business days, credentialing included.
Onboarding is a fixed plan with named owners on both sides. First signed report within 10 business days of countersignature.
Credentialing and connection
Licence and credential files reach your medical staff office. The site-to-site VPN or TLS link is established and tested against your PACS.
Routing and test studies
DICOM routing is configured and test studies run in both directions. HL7 results are verified inside your RIS before any live patient work.
First live overnight reports
Overnight volume begins. A named clinical liaison and a named operations contact stay with your account from day one.
First signed report within 10 business days of countersignature.
Liability, your security review, and licensure across state lines.
Liability, and who is the physician of record
The radiologist who reads the study signs it under their own name and is the physician of record for that interpretation, and every reader on the panel carries professional liability insurance. Credential files are available during procurement so your risk officer can see who is reading before you sign.
Who reads, and who signsData handling, and the security review your CIO runs
A signed business associate agreement is a precondition of service. Studies are encrypted in transit and at rest, access is scoped by role and by facility, and every state change on a study lands in an append-only audit log.
Compliance and data handlingState licensure, checked study by study
The panel holds licences in all 50 states, and a study is routed only to a radiologist licensed in the state where it was acquired. Every read happens inside the United States.
How state licensure worksFour pages worth reading before you take this to your board.
- Nighthawk coverage, staffed as a shiftWhy night reading here is a scheduled shift with a rested radiologist on it.
- STAT reads for the emergency departmentWhat the clock looks like on the studies your ED cannot hold a bed for.
- STAT, preliminary and final, explainedWhich document your chart actually needs, and why a prelim is a read you pay for twice.
- In-house against outsourced, with the arithmeticWhat a call schedule costs a small department once you count the reading days it consumes.
If this is not the right page, the same five questions are answered for an outpatient imaging center and for a private radiology group, each with the failure mode and the credentialing route for that kind of site. Everything AstraRad publishes about itself, including what it does not hold and does not publish, is on the facts page, and the escalation channels behind the coverage are on the support page.
Send us one night.
Tell us your modalities, your overnight volume and your urgency mix. A complete per-report rate card with turnaround tiers and SLA terms in writing lands within one business day.
24/7/365 coverage. Every read happens inside the United States.