In-network providers generally cannot balance bill patients. When a healthcare provider participates in an insurance network, they agree to accept the insurer’s contracted rates as payment in full for covered services. This means that the provider cannot charge patients for the difference between their usual fees and the lower rates negotiated with the insurer. An […]
The radiology billing and coding was usually seen as a bulky process. It is quite difficult to stay upgraded on different changes in rules and regulations of an individual payer. Irregularity in billing and coding can occur in the tough radiology environment. Moreover, this can create hurdles such as lost or under-coded filing and the […]
Acceptable HCPCS codes for radiology and other diagnostic services are taken primarily from the CPT-4 portion of HCPCS. Payment is the lower of the charge or the Medicare physician fee schedule amount. Deductible and coinsurance apply, and coinsurance is based on the allowed amount. For claims to A/B MACs (A) or (HHH), revenue codes, HCPCS […]
The goal of a well-managed radiology billing operation is to submit claims for services promptly and receive reimbursement as quickly as possible. Timely submission and prompt payment enhance the practice’s cash flow and keep the overall cost of billing at a minimum. All too often, however, payment is delayed because the payer denies the claim […]
Documentation of procedure is key in Radiology Medical Billing The brilliant principle for therapeutic charging has dependably been “If it’s not archived, it wasn’t finished.” For demonstrative imaging focuses, that is particularly valid, where exact repayment relies on very exact documentation and coding. What’s more, in case you’re not hitting the nail on the head, […]
Radiology practices involve complex billing and coding. Practices find it tough to stay up to date. Radiology practices, like other specialty practices, offer a variety of different services like intrusive procedures, and other incursions to the patients in a variety of different settings. The charges for the services are dealt with differently depending on where […]
Radiology is the most fragmented specialty with primary patient care and consultation as the major focus. A radiologist plays a role as a consultant covering various medical imaging for other specialty diagnoses. A radiology practice is sequenced according to the geographic area, radiologist struggle with a different universal set of medical practices. It’s cumbersome for […]
The American Medical Association (AMA) has released a total of 542 CPT code changes under the CPT coding manuals for 2015. Fifteen new codes have been introduced under radiology billing in 2015, while 23 codes have been removed. The AMA has also revised four codes for radiology billing. These changes will majorly impact vascular and […]
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