Radiology

Outsourcing of radiology billing services has become a common trend in the US healthcare industry. Healthcare experts are choosing to hire a reliable medical billing partner to ensure accuracy in claims submission . This is because lack of time and manpower has made it daunting for radiologists to keep a track of billing and coding processes. Billing inefficiencies are not only resulting in denials and affecting payments but also impacting the integrity of the practice. Radiology practices are constantly under pressure to prove their value and stay ahead of the curve. Considering the changes in payment models and introduction of quality measures, they have to make more efforts in order to thrive and survive in the changing landscape. If claim denials and delayed payments have been an issue for your radiology practice as well, then you need to take necessary measures in order to get your practice back on track. Here are some of the common radiology billing challenges that may...

If you are a practice that wishes to contract with third-party payers, then it is necessary that you attest to the qualifications and competencies of your physicians. This needs to be done through a process of source verification, data collection and committee review. If the physicians are not credentialed properly by an insurance company, then they won’t get paid on time for treatment of patients that are covered by that plan. This will result in a direct hit to the revenue cycle of your practice. Even if the physicians see the patients, the patients will be charged a higher deductible or out-of-network copay, which will be hard to collect because eventually, a great deal winds up in collections. Provider credentialing is a critical process for ensuring quality care and strengthening the practice’s financial health but such legwork also creates administrative burden. From source verification and certifications to experience, training, residency and licenses, there are various fa...

Coding precision is vital for radiology practices to get paid for rendered services. Since coding inconsistencies are quite common in radiology environments, it becomes necessary to have expert billers and coders working for the practice . The main reason behind coding inconsistencies is that the professional and technical billing processes don’t often overlap. There are chances a technologist focused on patient care will miss the charge-capture updates that are required for reflecting a change in patient procedures or supplies being used. Even a busy radiologist may interpret an exam using a different procedure name or may not have the necessary documentation for supporting coding for a certain procedure even though it was completed. Due to this disconnect, a greater risk of compliance issue crops up and it leads to under-coded or lost charges. Every radiology practice is dependent on the proper execution of a complex chain of diagnosis and disease coding and procedural cod...