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The Role of radiology in Hospital Revenue

April 25, 2012

Radiologists are playing an ever increasing role in hospitals and these deeper involvements are due to numerous factors. The outcomes of such an ever increasing involvement of radiologists in hospitals can bring about positive outcomes not just in the core aspects of medicine and for patients but also in the form of pecuniary benefits in the long run for almost all the parties involved in delivering healthcare as well as the recipient of such health care. Moreover, the fact that in terms of revenue, radiology makes an immense contribution to hospitals; especially in community hospitals where cardiology produces almost only one third of what the radiology services generate makes this specialty lucrative for hospitals. MRI (Magnetic Resonance Imaging) and CT (Computed Tomography – CAT scan) services in the hospital radiology departments are the areas that generate a lot of revenue. However, as the demand from hospitals increase for timely and accurate delivery of services, the workloads and pressures on radiologists is also increasing.

Nowadays, the intense utilization of, ultra-sonography, computed tomography and to a minor degree magnetic resonance imaging to check patients treated in the emergency department has altered the amount and type of work required by radiologists. Technological progress in digital imaging have also facilitated the images created to be processed, operated on and also broadcasted quickly all over the country to be examined concurrently with the broadcasting centre. Moreover, the advance in health IT in the form of EHRs has also has a profound effect on the way radiology billing services are carried out. A storage space like an EHR may only seem a storage entity but it has immense implications for radiology. It is important to accomplish a competent workflow process during the life cycle of the images and the additional data, and radiology can accomplish this, thus creating quality and positive quantitative results.

Another reason that hospitals can generate more revenue in the radiology department is that there is scope of accommodating many more patients due to short scan times. This fact is important since the number of insured in the country is going to increase dramatically and radiology can cope with such demand and generate more revenue in the future. A simple SWOT (Strength, Weakness, Opportunities, and Threats) analysis of hospitals in the United States would reveal that as far as revenue is considered radiology is one the biggest strengths. However, there are also numerous threats such as new and stiff competition in the form of specialized radiology services that are stand-alone in nature and other challenges arising out of the federal reforms.

The challenges and opportunities for hospital based radiologists and radiology departments do not just stop at IT implementation, increased workload, and the reform compliance. The biggest challenge for hospitals is getting paid for their jobs in an accurate and timely manner. The processes involved in accomplishing this goal of revenue enhancement and generation have also changed due to the reforms. Changes in billing codes from ICD-9 to ICD-10, HIPAA compliance, adoption of 5010 platform and changed insurance policies have made streamlining of these processes very important in light of the future volume and quality that is to be achieved.

To accommodate the amount of billing and coding volume in the future, it is important for hospital based radiology departments to look at outsourcing the departmental processes such as revenue cycle management, denial management, interaction with payers, HIPAA compliance in order to cut costs, free up time and resources for the core aspects of medicine or administration in the hospital. Medicalbillersandcoders.com is the largest consortium of medical billers and coders that offer all the services mentioned above in addition to numerous other value added services helpful for physicians and hospitals.



Category : Revenue Cycle Management