In Search of Resources to Counter Radiology Billing and Compliance Challenges

Much like medical billing challenges faced by other practitioners, radiologists too will have challenges unique to their own profession. The general perception of billing being more complex than ever before and progressive fall in reimbursements seems to hold good to Radiology Billing as well. As a result, radiologists may see their revenues dropping considerably, which in turn could have disastrous impact on clinical and operational efficiency.   With possible threat to sustain diagnostic and radiologic quality amidst a host of clinical and Radiology medical billing challenges, radiologists will have to identify and address the key factors that may carry potentially greatest threats to their revenues, profitability, and more importantly the patient care.

  • Foremost, bundling of services and codes could lead to significant decrease in reimbursement for radiologists.  It may be remembered that certain radiology codes are now modified into codes with lower RVUs. Moreover, The Medicare Payment Advisory Committee’s (MedPAC) inclination to reduce imaging reimbursements, including lowering the threshold for bundling review from 75% to as low as 50%, reducing professional component payments for multiple procedures and studies conducted by the same practitioner during the same session, and discounting payments for radiologists who both order and read images could severely hamper radiologists’ revenue prospects.
  • Second, the enormity of radiology coding revisions will require radiologists to undergo training to comply with new coding order.  And, training for ICD-10 compliant radiology coding will not be all that easy simply because the electronic data standards and requirements, lengthy alpha-numeric codes, a whole set of new RVUs,   and the obligation to comply with PQRS standards for Radiology Billing and reimbursements.
  • Most importantly, the new ICD-10 coding system could prove to be the most financially taxing of all that clinical and operational migrations that radiologists may have undertaken thus far – upgrading of technology that necessitates ICD-10 compliance is expected to cost radiologists as high as major capital investments. Coupled with this heavy financial expenditure, radiologists may be required to carry on with dual systems – both ICD-9 and ICD-10 – till such time when ICD-10 system becomes omnipresent. Thus, the duality of coding too will be more taxing both mentally as well as financially.

The enormity of these radiology billing challenges could throw radiologists into a phase of great uncertainty. Thus, it may require unusual acumen to respond to changing radiology coding and compliance requirements. And, who better to manage the business side of your practice than radiology specialists that possess the expertise to understand the dynamics of such radiology coding and billing compliance.

Quite aptly, happens to be the platform that can enable the deployment of such radiology billing specialists to practicing radiologists across the 50 states in the U.S.  Its affiliation with chosen pool of radiologists makes it the most reliable source for radiologic medical billing resources to counter radiology billing and compliance challenges. The service portfolio of these radiology billing experts include demographic/charge information, data accuracy verification, coding from physician reports, analysis of  billed charge fee schedule with recommendations, direct claims submission, revenue cycle management,  administration of patient payment plans, responding to patient and insurance inquiries, collecting, depositing payments and performing  refund reconciliation of overpayments, Medicaid pending account research, legal account follow up, carrier arbitration and government payor issue resolution, streamlined appeals process, monitoring accounts receivable, complete and detailed billing management reports.