- July 7, 2023
- Posted by: Thomas Anderson
- Category: Radiology Billing
In the realm of medical billing, errors can be really expensive. And billing for Radiology practices is no different. The Radiology billing process has a lot of hurdles, and it’s quite difficult to stay up-to-date on different changes in rules and guidelines of imaging coding and billing requirements. Claim denials and payment delays are not only disappointing to radiology practices, but also extend the timeline for patient check-ups, leading to wasted healthcare provider hours and idle machines. It is unfortunate that majority of the errors are identified at the time of claim rejection or during audits. The reality is, they could have been avoided easily at an earlier point in time. But more on that later.
3 Most Common Radiology Billing Errors That Can Affect Radiology Revenue Cycle
Incomplete/inaccurate patient records
Entering inaccurate patient details in a medical documentation is more dangerous than missing information. To get on-time claims and reimbursements, it’s important to capture the right details of the patient, like the medical diagnosis and insurance policy details. Payers audit all these details before paying any amount to the provider. In most cases, a claim needs to be accompanied by adequate documentation that clearly establish the nature of and the necessity for the procedure. Failing to comply with any of these may lead to a summary rejection of the submitted claim.
Termination of Coverage
It is highly important to check/review a patient’s health plan eligibility for the test. Furthermore, providers need to verify other parameters such as termination of coverage, patient’s insurance information, maximum benefit of the cover, and if the services offered are parts of the coverage. If these details are not captured properly, then radiology practices might face consequences like claim denials, delays in payment, and reimbursement obstacles.
Increasing staff shortage in the healthcare domain is one of the main challenges radiologists face today. The shortage of skilled billing and coding staff can lead to longer billing time, billing errors and backlog of claims. On the other hand, employing new staff can also increase operational cost substantially. It is really a Catch-22 situation, but the crux is, without trained RCM personnel, billing & coding operations can take a serious hit.
How RCM Companies Can Help in Imaging Billing Services?
The US healthcare industry is evolving, updating guidelines and becoming complex with every passing day. Facing losses and challenges at the same time, healthcare leaders have turned to outsourcing medical billing companies for immediate solutions to the problems they’ve been facing in radiology billing services, coding and revenue cycle management. This shift towards outsourcing imaging billing is driven by the challenges discussed above.
The benefits to be had from such a strategic move are many. For one, it helps reduce collection costs drastically. It also allows Radiology practices get instant access to a vast pool of trained billers and coders to help them with their claim management affairs. And professional intervention like this almost always helps in streamlining billing operations and making administrative affairs more efficient.