Imaging involves the use of various imaging technologies like ultrasounds, MRI, and X-rays. It creates the need for specialized billing services due to the complexities of these imaging techniques. Many radiologists overlook opportunities that help to maximize their revenue. This is because they are mostly preoccupied with clinical and administrative tasks. Professional imaging centers billing services assist radiologists to identify these opportunities along with ensuring billing accuracy and revenue generation. \
The annual change in CMS policies and medical codes causes significant billing challenges for radiologists. The claims are denied, reimbursement rates decrease, and imaging clinics face substantial financial loss. Thus, it is necessary for imaging service providers to identify the hidden revenue opportunities and capitalize on them for an improved billing practice.
The areas of revenue improvement in imaging centers billing
Every healthcare specialty has opportunities for improvement in revenue generation. Most healthcare billing companies are structured to process claims. Imaging centers billing refers to the specialized process of documenting, coding, and submitting claims for efficient reimbursement of services offered at imaging clinics. The most widely performed imaging test in radiology is X-Ray. Professional billing companies focus on the technical and professional components which are important for the reimbursement of X-Rays conducted by radiologists. Imaging practices generally operate at high volumes, which often creates errors in coding or documentation. In addition to securing proper reimbursement for the services, imaging clinics also have certain areas where they can improve their revenue.
1) Enhanced adherence to payer requirements – Every insurance company has its own specific set of reimbursement policies. These policies are different for Medicare, Medicaid, and other private payers. The in-house billing teams need to be aligned with different insurance policies. In the case of Medicare, the technical component is covered under the insurance policy that includes equipment and personnel. For patients treated in a hospital, the technical component is paid directly to the hospital instead of the physician. Professional billing companies conduct thorough verification of payer policies and the imaging services that are covered.
2) Streamlined claim processing and faster reimbursements – Submitting claims on time is one of the contributing factors to an improved billing system. Insurance companies have a specific timely filing limit (TFL), within which the claims need to be submitted. Many radiologists lose potential revenue due to late submission of claims. Payers often reject claims when they are not submitted within the time limit. This leads to an increase in claim denials and further revenue loss. An imaging billing solution strictly follows the specific claim submission timeline and ensures that radiologists are reimbursed on time.
3) Accurate coding for enhanced revenue recovery – Medical codes are updated every year by the American Medical Association. It is of paramount importance for the in-house imaging billing team to stay updated with new codes and modifiers. The transition from component coding to global billing and the expansion of add-on codes create more chances for coding errors. Professional radiology revenue cycle management companies have trained team members who are experienced in handling updated imaging billing codes. They implement the correct use of modifiers like –26 for professional components and TC for technical components. They also ensure that the bundled code 74174 is not being billed at lower rates. Some payers reimburse imaging services for a certain set of codes. The diagnostic imaging billing companies verify these codes so that providers are reimbursed effectively for their diagnostic services.
4) Achieving financial accuracy with advanced technology – Implementing the use of software like AdvancedMD and CareCloud, helps the imaging service providers address billing challenges. These tools, used by imaging billing solutions, highlight important information like time of claim submission, number of denied claims, and time of reimbursement. The application of various software also helps in comparing profitability across modalities like CT scan, ultrasound, and MRI. These software track how much revenue each imaging modality (CT scan or MRI) generates for the imaging center. They also help analyze profit margins for each type of diagnostic scan.
5) Efficient billing with outsourced experts – Hiring and training in-house staff is time-consuming and expensive for imaging clinics. The purchase of licensed software can be expensive for your practice. The outsourced billing professionals have updated software licenses and coding knowledge that reduces the burden of your in-house billing staff. Outsourcing is a major opportunity to maximize revenue for radiology clinics.
Why should you partner with an imaging centers billing company
Evolving healthcare regulations and medical codes have increased the demand for professional medical billing solutions. These companies offer benefits like $7 an hour service charge, no binding contracts, 30 days of free trial, and dedicated account managers. This provides a chance for the providers to explore the wide range of services offered by the billing companies. These different key features of imaging billing companies create an opportunity for maximizing revenue. Radiologists often require additional assistance when it comes to imaging tests like X-Rays, MRIs, and CT scans.
An expert imaging center billing solution like SunKnowledge offers end-to-end RCM services that cover pre-billing, billing, and post-billing. Their enhanced virtual assistant services like scheduling patient appointments, setting up appointment reminders, and responding to voicemail help streamline the entire billing process. In case of increased claim denials and loss of revenue, engaging professional billing experts can help optimize reimbursement rates and strengthen your overall financial performance.
