Tips to improve Radiology Billing in Healthcare Billing Services

Is it not important to keep up with regulations and changes, even if you outsource your radiology billing to healthcare billing services? For most of the radiologists, billing and coding have always been troublesome. They have been working hard to keep their billing and coding on track. Yet, they fail at some point.

It’s difficult to remain up to-date on all the regulations and individual payer changes. It is also imperative for the radiology practice to thrive. Even though radiologists outsource their billing and coding practices to healthcare billing services, it’s significant for them to be aware of what they can do to help in the processes. It can help them enhance or secure their practice in today’s world of auditing and financial outcomes.

Here are few tips to keep the radiology billing and coding on track.

Tips to improve Radiology Billing in Healthcare Billing Services:

  1. Monitor medical necessity
  2. Keep dictation needs up to date
  3. Review the templates and exam titles
  4. Communicate with the healthcare billing services company
  5. Create a process for report discrepancies


Monitor medical necessity:

  • Monitoring the medical necessity and asking for advanced beneficiary notices on Medicare patients is essential to run a successful radiology billing practice.
  • If a radiology service is not covered by Medicare due to lack of medical necessity, advanced beneficiary notices are recommended for the patient.
  • Advanced Beneficiary Notices cover the facility’s technical components and the professional component fee.
  • The professional component ABN is frequently missed because of the assistance required from the facility staff as well as the transmittal of the ABN back to the healthcare billing services.
  • The radiology professional must work with the facility staff at a hospital in order to make sure that advanced beneficiary notices also list out the professional component fee.
  • Beyond that, radiologists will need to request their healthcare billing services to monitor the trends from the ordering healthcare professionals.
  • Healthcare professionals also must be aware of the Medicare covered conditions prior to writing an order for the specific service
  • Radiology professionals must co-ordinate with the healthcare billing companies to receive a copy of advanced beneficiary notice from the patient. The above co-ordination might seem difficult at first but once the process is on track, radiologists will have the chance of experiencing fewer patient write-offs.

Keep dictation needs up to date:

  • By staying up to date on required dictation needs, it’s possible for audits like Recovery Audit Contractors (RACs) and Comprehensive Error Rate Testing (CERTs)to become a part of standard processes. Radiologists need to be aware of the verbiage needed to describe the exams performed.
  • Getting to know the accurate verbiage will help them to eliminate the expensive appeals and provide the additional information long after the original date of service.
  • For example, if a healthcare professional is dictating a CTA, they should include documentation of 3D imaging, which is necessary.
  • If a radiology professional does not receive the communication on CPT updates, feedback on documentation and where opportunities exist from their billing company, then they should definitely ask for it.
  • Resources that help in identifying documentation requirements include the current version of AMA CPT, CPT Assistant and Clinical Examples in Radiology.

Review the templates and exam titles:

  • Reviewing the templates and exam titles is necessary because of high volume exams. Most of the radiology professionals make an attempt to create templates and ensure whether all the applicable documentations are addressed without fail.
  • These templates should be checked thoroughly with the CPT updates to make sure they’re still current.
  • In case the group changes the equipment, technique, or the protocol, it’s recommended to audit these templates when the change occurs.
  • For example, if the radiology professional or radiologist has been using analogue equipment and has changed to digital mammography equipment, then the template should be updated to reflect that particular change.

Communicate with the Healthcare Billing Services Company:

  • Communicating with the healthcare billing company is essential to maintain a clean relationship.
  • When a change occurs in the equipment, techniques or protocols, the radiology group practices need to notify it to their Healthcare Billing Services Company.
  • During the change, the radiology professionals must review and update the templates as discussed earlier.
  • The Healthcare Billing Service Companies also must be aware of the change and also act as the safety check for the group.
  • Ultimately, the radiology group of practices must be responsible for the template updates, and at the same time, healthcare billing company should double check them for accuracy and timely updates.

Create a process for report discrepancies:

  • Creating a process for report discrepancies is important. Occasional discrepancies in the documentation, such as number of views, are inevitable. A group will have an eye on accurate payments for the services performed, along with fewer denials and auditing issues, when they have a billing company that is willing to communicate the information that can be improved upon.
  • For example, few healthcare billing services companies provide clients with quarterly dictation opportunities focusing on the areas where trends have been established, whether it occurs at a specific facility, physician or exam level.
  • This seems to be an efficient way to work through discrepancies with the radiologists.

How much will radiology diagnostic services cost?

  • The amount paid by the patient for imaging study depends on the various factors, including the type of imaging exam you are undergoing, where your imaging is performed, whether you have health insurance, the type of insurance and the insurance plan’s requirements.
  • The amount charged for the patient and an imaging exam depends on your insurance company and coverage. He/she may be charged a fixed fee, negotiated by the company and healthcare provider, or the insurance plan may require you to pay a percentage of charges over and above your premium, co-pay, or any deductible.
  • It’s always advisable to contact the insurance provider in order to understand how the charges are determined.
  • If the patient has no insurance, discuss uninsured fees with the hospital facility where you will be having your imaging done and ask them to include the professional fees and the facility fees.


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