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The healthcare environment is changing and radiologists are facing various challenges related to revenue cycle management, strategic growth and compliance. Considering the volume of diagnosis codes and procedures, radiology billing has turned into a complex task, creating more room for errors.

Due to the rise in complex regulatory environment and managed care, radiologists are being forced to spend more money on employees and training along with close monitoring of account receivables. This is happening at a time when reimbursements are reducing for radiologist due to rationalization of admissible radiologic expense for Part B imaging services on par with industry standards.

Some of the challenges faced by radiology practices include:

  • Reduced reimbursements
  • Growing focus on recovery audits that target reimbursement errors
  • Errors in documentation due to lack of time
  • Lack of latest practice management resources
  • Increased billing error monitoring

Measures to face radiology medical billing challenges:

Providers will have to distinguish the connection between procedural coding systems and diagnosis coding and system that provide a certain method of describing procedures, diseases and diagnoses. Radiologists while diagnosing high-cost tests have also become bounded by the medical necessity clause. Since medical necessity of high-cost diagnostic radiology tests need to be proved under Medicare, radiologists will have to remain extra careful.

They will have to monitor medical necessity and ask for advanced beneficiary notices on Medicare patients. Exam titles and templates will have to be reviewed annually with the CPT updates to ensure if they are still current.

Communication will have to be established with the billing department on regular intervals to inform them if there have been any changes in techniques, equipment or protocol. A process will be required for report discrepancies to avoid auditing issues and reduce claim denials.

If the above-mentioned measures are not taken seriously by providers, financial health of their practice will get affected to a great extent. It could even lead to their practice getting black listed for repeating billing errors. Therefore, it is essential for them to stay away from any issues under Medicaid, Medicare, HHS programs or commercial health insurance plans.

Due to lack of time, money and resources, many radiologists fail to solve radiology medical billing issues that disrupt the cash flow of their practice. To get things back on track, they seek assistance from a billing company that specializes in radiology billing. is a billing company having nation-wide affiliation with the best radiology billing specialists. We have an expert team of coders and billers who can offer their competency and experience to address radiology billing challenges for your practice. Our aim is to strengthen the financial health of your practice, maximize revenue and minimize claim denials. The team at MBC is well-trained and certified and we make use of the latest technology to offer you the best results. While an expert team is taking care of your revenue cycle management, you can use the spare time to concentrate on quality patient care.

Published By - Medical Billers and Coders
Published Date - Jan-28-2014 Back

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