Final vs Preliminary in Teleradiology

What exactly is the difference between a final report and a preliminary report? Depending on who you ask you could receive several different answers.

The most common answer you will receive is that a preliminary report is one read by a radiologist who does not have a license for the state the images were taken in. This preliminary report would be read as a final within twenty-four hours. The final report would be read by a radiologist who does have a license in the state the images were taken in.

Another common answer is that a preliminary report is one read by a radiologist who does have a license for the state the images were taken in, but that has not been through the credentialing process for the hospital or facility that took the images. The final report, read later, would be read by a radiologist who has both a state license and that has also been through the credentialing process for the facility.

The future of preliminaries and finals revolves around sub-speciality radiologists. In this scenario a preliminary is the report read by a radiologist who has a state license, and has been credentialed, but the radiologist does not possess the sub-speciality skills to fully interpret the exam. The final report would be read by a radiologist who has sub-specialty training that applies to the specific exam. As an example, for a head CT, the preliminary would be read by the first radiologist available to read it. The final report would be later read by a radiologist with a neurology sub-specialty.

Typically a hospital or facility would only pay for a final report. In the sub-speciality model of preliminaries and final reports the hospital would pay for both reports. In some cases paying more for the final than for the preliminary.