Common Errors in Radiology Billing Services

ByWilfred
Common Errors in Radiology Billing Services

You face numerous obstacles in the radiology billing reimbursement process. Claim rejections and delays not only disappoint your imaging center but also highlight the prolonged timeline for patient care, idle machines, and wasted physician hours. Over the past few years, imaging centers have seen a rise in claim rejections, sometimes by up to 83 percent.

The increasing number of authorization-required processes has led to issues in matching clinical requirements due to the lack of documentation from referring physicians and continuous changes to payer and benefit management guidelines and policies.

When it comes to diagnostic imaging centers, the saying “if it’s not documented, it wasn’t done” rings true in cardiology billing services. Billing depends heavily on precise documentation and coding.

Time to know about the common mistakes in radiology billing services–

1) Incomplete imaging reporting:

The American College of Radiology requires all imaging reports to include essential information for a complete report:

  • Description of the exam, sequences, and / or technique
  • Name of the exam
  • Physician’s signature
  • Comparison studies if applicable
  • Clinical indication/reason for the exam
  • Findings
  • Conclusion and recommendations, if provided

From a coding perspective, important components also include laterality. If any of these components are missing, your compensation may be delayed or reduced.

2) Incomplete claim information:

Accuracy plays a vital role in your radiology billing services. Incomplete information often causes denials for most radiology practices. Missing any of the information mentioned below can cause claim rejection or postponement-

  • Patient identification and group number
  • Ordering care provider’s name
  • Patient phone number
  • Ordering care provider’s email address
  • National Provider Identifier number
  • Patient’s date of birth
  • Ordering care provider’s mailing address
  • Ordering care provider’s phone and fax number
  • Patient name
  • Patient address
  • Ordering care provider’s tax number

In case of a rejection due to incorrect insurance information, you may need to submit an application.

3) Failure to check termination of services or not covered:

Understanding both the patient’s insurance plan and the services you’re providing is crucial. Always check the patient’s eligibility whenever you offer services. Additionally, crosscheck other factors such as coverage termination, whether the services you offer are part of their plan, and whether they’ve reached their maximum benefit. Reviewing the patient’s insurance details is extremely important. Failing to do so could result in consequences like claim rejection and delays in reimbursement.

4) Lack of prior authorization:

When you are planning advanced outpatient imaging procedures like PET scans, CT scans, MRIs, and others, health carriers often require prior authorization. It’s the responsibility of the provider who recommends these procedures to get prior authorization before scheduling. However, the imaging provider may contact the recommended provider and ask them to obtain a prior authorization number before scheduling the imaging procedure.

Furthermore, there’s a possibility that you might not be billed for services. To get reimbursed, your prior authorization must be backed by medical necessity, requested by the provider listed in the authorization or recommendation, and submitted on time. You need to meet all these requirements to receive reimbursement.

Are you also facing the same hurdles in your practice and losing revenue? No worries, partnering up with a perfect radiology billing company enables you to avoid all these billing mistakes, while you can put complete focus on diagnoses. Outsource your billing responsibilities to Sunknowledge and see the difference.

Enjoy maximum reimbursements by outsourcing radiology billing services:

We, at Sunknowledge,we offer end-to-end radiology billing services across the nation. With more than a decade of industry experience, we have enabled hundreds of radiology practices to streamline their revenue cycle management. We are completely familiar with all the critical challenges in your radiology billing and know how to mitigate them.

So, what are you waiting for? Outsource your radiology billing services to us and enjoy seeing an almost 80% boost to your practice revenue.

Dorian Wilfred boasts over a decade of expertise as a medical transcriptionist, specializing in healthcare medical billing, revenue cycle management, and claim administration. With a keen eye for detail, he excels in collecting funds from insurance companies in the USA, ensuring accuracy and compliance. Dorian's proficiency has significantly contributed to streamlined communication among healthcare providers and optimized financial operations. His track record underscores a commitment to precision, reducing errors, and maximizing revenue streams. In the dynamic realm of medical billing, Dorian stands out as a trusted professional with a proven ability to enhance operational efficiency.