#radiology practice

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3 Factors that affect Revenue for your Radiology Billing - 24/7 Medical Billing Services

Are you observing too many denials with your radiology practice? Speak with a 24/7 Medical Billing Services Revenue Cycle Management Special

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What is the best solution for radiology coding issues? - 247 Medical Billing Services

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

What is the best solution for radiology coding issues?

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How to keep radiology claims denials at bay?

In order to run a successful radiology practice, it is important to ensure that claims for services are submitted on time. This will not only enhance the cash flow of the practice but also keep the overall billing expenses at a minimum. 

Common Reasons why Radiology Claims are Denied

The need for timely and error-free claims submission is evident but at times, claims get denied by payers due to various reasons, such as, patient eligibility issues, failure in obtaining authorisation for a radiology procedure or insufficient documentation about the medical necessity of an examination.

When it comes to patient eligibility, it is necessary that the radiology practice is mentioning the correct site of service or the correct information about the insurance company (or plan) in the claim. If the information doesn’t correspond with the payer’s records, claim will be denied and sent back to the practice for correction.

With ICD-10 diagnosis coding, level of specificity needed in pre-authorisation for imaging procedures has increased to a great extent. If these services are being performed by the radiology practice without obtaining prior authorisation, it will result in denials. Claims will also get denied if there is a mismatch between authorisation and exams performed.

Similarly, if there is lack of good documentation supporting the reason for performing an examination, then also claims will be denied because payers have strict protocols dictating the conditions under which certain procedures should be performed.

Keeping Radiology Claims Denials at Bay

There are several factors that a radiology practice needs to consider in order to reduce denials in the first place. For instance, practises need to identify the source of denials and ensure that there are no data entry errors at the time of registration.

The practice should review its medical coding process because coding error can also result in delayed or denied payments. A good authorisation management system should be implemented and authorisation denials should be regularly monitored and tracked to identify the source of problem. It is necessary to take a proactive approach towards medical necessity and CDI (Clinical Documentation Improvement) as well.

Many radiology practices prefer to outsource billing tasks to a third party because it gives them the freedom to focus on patient care. By letting a reputed medical billing company handle their revenue related worries, they manage claims denials proactively and get paid on time.

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