Adverse Effects of Inefficient Radiology Medical Billing

It’s not a hidden secret anymore, or an unknown fact, that determines the adverse effects of inefficient radiology medical billing can have on the doctor’s office. Every medical practitioner today is more than obliged to have reliable and knowledge based in-house accounts department to charge the patients appropriately. But lack of knowledge and high number of coding errors are a letdown for many Radiologist. Keeping up with the latest billing and coding perquisites, it’s a better idea to completely outsource the work to professional medical billing company.

Mistakes in medical billing can be a costly affair, and hospitals have to be more careful now, right from the front-end to back-end of patient care and consideration. Furthermore, errors can be costly mistakes that lower the reimbursement by five percent of an average practitioner’s quarter of million dollars. Plus, they increment days in A/R, delay repayment, and can even lead to compliance violations.

In today’s time of decreased radiology repayment, finding and fixing the loop holes in the billing cycles stands vital. In this article we will look at some common mistakes that can have adverse effects on your practice as a Radiologist.

Eligibility Errors

Eligibility errors are the main reason as to why your revenue cycle management gets hampered, making up no less than 35 to 40 percent of denials. In a doctor’s facility based radiology practice, we prescribe that the radiology head and his/her charging specialists (in-house billing experts) meet with doctor’s facility organization to audit and examine eligibility denial results. The doctor’s facility should be intrigued since they are doubtlessly encountering denials from the same flawed information. Hence, recommending upgrades to the healing center’s procedure, for example, online eligibility checks can be generally welcomed.

The front end procedure is under the immediate control of imaging center authority, making it much less demanding to address furthermore, decrease eligibility errors. We suggest an online qualification check at the time when a procedure is scheduled, especially MR’s, CT’s, and PET’s.

Referral errors

It is not extraordinary for a radiologist to do a study that is then denied by a healthcare payer because the billed study is not the same as the referring doctor requested. Consider the situation where an imaging center request and pre-cert a MRI without difference, but the practice or the radiologist, has published protocols to both the study, with and without difference. If both the studies are charged, the payer will doubtlessly deny the case since it doesn’t coordinate the referral.

For imaging centers, the arrangement is to have rock-solid front-end strategies that require the request and precertification (commercial payers) with a specific end goal to plan a procedure, and for the center to review and request and pre-cert before the appointment to ensure it coordinates their protocols. Do remember that if referral errors are not identified by the in-house billing department, sourcing the work to an accredited radiology billing and coding company can reduce the A/R days and also the delay in reimbursement.

Transcription ERRORS

All radiology physicians realize that right system codes and modifiers are required for insurers to acknowledge their claims and to get the right repayment. Transcription errors and incomplete documentation can hamper the growth of your facility and the staff. Also, if you have lost the frequent patients that used to visit you every month with their problems, may look for a more complete and upgraded radiology facility to get the procedures done. With outsourcing radiology medical billing undertaking you can expect precise transcription for all your claims.

If your radiology practice concentrates on eliminating these 3 errors, you will see diminished rate of refusals which will interpret to enhanced income and lessened operational costs. Make sure to screen the patterns in your monthly reports so that you are aware and mindful of any future slippage.