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Radiology Billing and Coding Services to Optimize Downward Reimbursement Pressures

May 19, 2017



Radiology-Billing-and-Coding-Services-to-Optimize-Downward-Reimbursement-Pressures

Downward reimbursement pressures in Radiology practice is a bad omen that has struck this specialty in the healthcare industry. Right from expanding operational expenses and shifting payer rules, to HIPPA, Medicare and Medicaid compliances Radiology facilities are railing under some tremendous financial pressure. With so many forces destructively impacting the profit margins, it's more important than ever to ensure you're repaid every available dollar you've earned.

Growing focus on outsourced Radiology billing

The greatest challenge for today's Radiologists, is securing every collectible dollar, but with lower billing cost. However, this is no easy feat as payment responsibility shifts from institutional payers to patients, whose dollars are more difficult to collect. Thus, many Radiologists are giving their billing requirements to the professional as opposed to keeping it in-house.

Outsourced billing services possess the expertise to decrease the risk of payment denial or missed earning charges, lower costs, and improve an organization's bottom line, while allowing the in-house staff to focus on delivering quality care. During the past year, nearly half of the major physician facilities residing in the most prominent states of US opted to outsource billing operations to a company, rather than continue performing them in-house.

The cost of collections is a substantial component of any practice's overhead, and so is the billing function critical to the facilities success and survival. Costs inevitably rise as staff payment increases along with technology and other overhead expenses. Monetary collections simultaneously decline due to reimbursement cuts. Fixing this variable cost and employing quality billing companies and utilizing their resources can be a win-win business arrangement for physician practices.

An outsourced radiology billing company can reduce the cost of billing and improve collections by capturing every charge and ensuring it is paid appropriately. Subcontracting these important functions can result in consistent improvement in collections and reimbursement reliability and cost-effectiveness.

Augmenting reimbursement through coding

Most practices including Radiologist lose significant income because of incomplete dictation and inaccurate coding and billing. This problem becomes more complicated as pressure to obtain reimbursement pushes practitioner to do more with fewer resources in an effort to cut costs.

Today, with the advent of billing software's, a facility can get real time information on all the charge entry, claims submission, following up, and computer-assisted technology to keep errors in billing away and ensure accuracy and optimum payment for radiologists' work. Cutting edge billing software can minimize denials up front and allow for increased accuracy and optimized payments, especially in the new ICD-10 coding atmosphere, which will increase the number of diagnosis codes.

The capacity to test a code's ability to pass the insurer's audit will become particularly demanding with the new ICD-10 codes and requires a greater level of specificity, which most of times is lacking in radiology documentation. A software assisted coding system allows the coder to run the selected entry through an editing function to see if it will pass. This makes billing more efficient, with a 45- to 60-day window being the standard.

Keep in mind that automated coding assistance technology makes it easier to assign codes and bill correctly, which means less errors, unpaid claims, and requests to resubmit claims with supporting reports.

 

Category : Outsource Medical Billing