Hospital-based radiology practices ensure quality radiology procedures to help physicians chart appropriate treatment procedures. The smooth functioning of these practices depends on proper revenue management and the smooth reimbursement of claims. To enhance their revenue, it is advisable for radiology practices to entrust their medical billing tasks to a professional medical billing company. An efficient service provider would ensure many benefits for independent radiology practices and radiology departments.

Accurate Medical Bills and Claims

Hiring medical billing services helps radiology practices manage their medical billing procedures in the proper manner. Considering the medical billing needs of hospital-based radiology practices, many well-known medical billing companies in the US offer structured radiology medical billing services. These services offer radiology practices the following advantages:

• Accurate medical bills and insurance claims
• Prompt submission of bills and claims
• Improved reimbursement and collections
• Less overhead costs
• All claims processed on the same day
• Use of advanced software such as Lytec, Misys, Medisoft, Medic, NextGen, Inception, and IDX, Eclipse, medical manager and e-clinical
• Interface with RIS (Radiology Information System)
• All claims transmitted electronically and filed after verification
• Minimizes the odds of claim denials or rejections
• Saves times and allows focus on core tasks
• HIPAA compliance

Efficient Medical Billing Solutions for all Procedures

Professional medical billing companies ensure that the radiology medical billing services they offer are fully compliant with the HIPAA norms, as well as competent to resolve the needs of hospital-based radiology practices. Most of these firms are equipped with advanced technology and the latest billing software as well as skilled billing and coding experts. This ensures client-focused medical billing procedures.

The major procedures covered in radiology medical billing are:

• Patient enrollment
• Payment posting with ERA
• Insurance verification
• Scheduling and Re-scheduling
• Insurance authorizations
• Coding
• Referrals
• Billing and reconciling of accounts
• Collections and AR collections

Regular Follow-up and Feedback

The radiology medical billing services that reliable medical billing companies offer ensure excellent data confidentiality, regular follow-up for all unpaid or denied claims, daily, weekly and monthly billing status reports, practice analysis reports, and more.

Hospital-based radiology practices planning to outsource their medical billing tasks should take care to assign the job to an established medical billing company. This would help them maximize their reimbursements and obtain consistent and budget-friendly medical billing solutions.

Medical billing is an important task in healthcare facilities. Medical practitioners have to find time to perform the billing tasks so as to maximize their reimbursements. Outsourcing of medical billing tasks to professional companies reduces their work load and increases their efficiency, as well as enables them to submit medical claims on time. All this significantly improves the cash flow of medical practices. Realizing the benefits of prompt submission of medical bills and insurance claims, an increased number of healthcare facilities are now outsourcing their medical billing jobs.

Committed Services Ensure Error-free Medical Bills

To help medical care providers reduce their workload and make their practices more efficient and profitable, many reliable outsourcing companies offer committed and customized services. These firms are staffed with a talented group of professionals including billing specialists, coders, accountants and others with exceptional expertise in utilizing advanced technology and HIPAA compliant medical billing software. Having comprehensive knowledge in all aspects of billing and claim processing procedures, they process medical claims quickly and without errors.  Important tasks performed in medical billing include:

• Patient enrollment and insurance enrollment
• Scheduling and rescheduling
• Insurance authorization and insurance verification
• Medical coding
• Billing and reconciling of accounts
• Account receivable collection and follow-up

Improves Cash Flow

Medical billing companies prepare both paper and electronic medical billing reports based on coding procedures of various diagnosis methods, patient visits, treatment methods and duration of treatment process. They ensure that their daily, weekly and monthly medical billing reports are error free, and follow up all unpaid insurance claims to make sure that are being processed correctly. They also see that full payment is made on all submitted medical claims. All this reduces the chances of claim rejections or denials, which considerably improves cash flow of the medical practice. The main services offered include:

• Three-tier quality check
• Excellent data confidentiality and security
• Customized turnaround time
• 24/7 customer support service
• Competitive pricing
• Free trial offer

Outsourcing of your medical billing tasks to a reputable and experienced service provider ensures quality services at reasonable charges.

Many outsourcing companies based in the USA offer radiology billing services to meet the needs of independent radiologists, radiology practices, multi-specialty practices, hospitals and other healthcare providers. Accurate radiology medical billing services help medical practices to maximize their reimbursement and improve their efficiency.

Services of Trained Staff for Accurate Results

Professional billing companies have trained and expert staff comprising certified medical billing specialists, coders, and AR callers with extensive experience in delivering accurate services. Making use of advanced web-based billing software in their billing procedures, they analyze your medical claims without errors and improve your reimbursements. With their special skills and knowledge in advanced billing software including NextGen, Medisoft, Lytec, Misys, IDX, Practice Admin and Inception, they can accurately process and submit your radiology bills. Covering all aspects of your medical billing requirements, they ensure quick and maximum reimbursement.

Some of the important factors that help in the delivery of accurate billing solutions are:

•    Regular QA checking with readily available reports
•    Analysis of accounts by experienced professionals including AAPC-certified coders
•    Flexibility in using medical billing software – they work with your current billing software or use our own software (Web-based with EMR)
•    Constant analysis for patterns on codes, procedures or any global problems with appropriate and timely reports.

Highlights of Radiology Medical Billing Services

Billing companies have simplified the radiology medical billing process for all sorts of radiology claims. The main medical billing procedures that medical billing companies cover as part of their billing services are:

•    Patient scheduling and reminders
•    Patient enrollment (demographics and charges)
•    Insurance enrollment (for physicians and offices)
•    Insurance verification
•    Insurance authorizations
•    Coding and audits
•    Billing and reconciling of accounts (payment posting)
•    Account analysis and denial management (EOB Analysis)
•    AR management (insurance and patient)
•    Financial management reporting

Find a Reliable Service Provider

To ensure accurate radiology medical billing services, the task should be outsourced to a professional medical billing company. Reliable service providers ensure compliance with HIPAA guidelines to guard against breech of confidentiality.

In view of the increased demand for medical billing, several recognized outsourcing companies provide efficient services in medical billing at cost-effective rates. These services enable healthcare experts to submit their medical bills and insurance claims accurately and in a timely manner.

Accuracy in Medical Bills and Claims

To deliver outstanding medical billing solutions, medical billing companies are equipped with a panel of experts including medical billing specialists, coders, accountants, auditors, quality analysts and others. Using advanced medical billing software, they process and submit medical bills and claims with great accuracy. The services provided include:

• Patient demographic entry
• Insurance enrollment
• Charge entry
• Insurance verification
• Billing and reconciling of accounts
• Payment posting
• Insurance authorization
• Medical coding
• Scheduling and rescheduling
• Account receivable follow-ups and collections

Focus on Core Competencies

By outsourcing their medical billing tasks, medical facilities can reduce a massive amount paper work in their offices. These services save the time and effort that healthcare professionals would need to do the job on their own. This lets them concentrate on their core competencies. Moreover, they can also reduce the expenses required for maintaining an additional workforce to do the billing tasks inside their facility. Outsourcing medical billing also offers like:

• Greater quality assurance
• Excellent data security and confidentiality
• HIPAA compliance
• Ensures maximum reimbursements
• Regular feedbacks and reports
• Precise solutions in rapid turnaround time
• 24/7 technical support

Cost-Effective Rates Medical Billing Services

When planning to outsource their medical billing jobs, healthcare facilities should ensure that they go in for the services of established medical billing outsourcing service providers. Experienced providers can offer reliable solutions at cost-effective rates.

Outsourcing your billing tasks to professional medical billing companies in US is highly beneficial in that they reduce your administrative burden to a large extent. US based medical billing companies have a lot of features and advantages:

• Maximize your reimbursements
• Lower organizational expenses
• Increase business efficiency
• Minimize back office expenses
• Ethical medical billing service
• High confidentiality
• Customized turnarounds
• Free trial
• 24/7 customer support
• Daily, weekly and monthly reports

Total Solution for Medical Billing

Medical billing companies in the US provide total solutions for all medical insurance related billing jobs. Outsourcing medical billing works to industry leaders saves a large amount of money and time. Furthermore, the companies also help you to enroll in various beneficial plans of insurance companies. The medical billing services of US based medical billing companies cover:

• Physician billing
• Medical insurance claims filing
• Patient collections
• Insurance claim submission
• Follow up with insurance companies
• Online reporting
• Customized billing procedures
• Electronic billing
• Charge entry
• Scheduling and rescheduling
• Cash posting and reconciliation
• Old accounts receivable collections
• Insurance verification
• Insurance authorization
• AR collections

Help to Stay Resolute in Medical Industry

Professional medical billing companies in the US ensure high quality and accuracy in the billing process. In order to provide quality service, the companies maintain adept medical billing professionals who utilize many advanced systems. For efficient electronic claims processing, the companies make use of state-of-the-art billing systems, electronic medical records (EMR) and electronic practice management (EPM) systems. Besides these facilities, leading companies employ modern software like NextGen, IDX, Medisoft, Inception, Lytec, Medic and Misys.

Radiologists perform both interventional and non-interventional/non-invasive procedures. Interventional radiology procedures include diagnostic radiology imaging and ultrasound, while non-interventional procedures comprise standard radiographs, single or multiple views, contrast studies, computerized tomography and magnetic resonance imaging.

To get proper reimbursement for the procedures they perform, radiologists need to execute proper disease and diagnosis coding or ICD-9 coding (using three-digit codes that are modified by including a fourth or fifth digit as characters following a decimal point), and procedural coding using Current Procedural Terminology (CPT), comprising 5 digits with 2-digit modifiers. The procedure will be considered medically necessary only with a supporting ICD-9 diagnostic code. Sometimes multiple codes, such as radiological and surgical codes may become necessary to report a full procedure. Cardiology medical billers have to be thorough with radiology CPT codes that are bundled with other CPT codes. When billing for radiology services, ‘upcoding’ (coding a higher or more complex level of service than what was actually performed) has to be strictly avoided since this is regarded as fraud or abuse. Another important factor is to ensure whether the services require prior authorization to be properly reimbursed by the carrier.

Radiology Codes

Radiology codes comprise the 70,000 series of codes organized by the method or type of radiology and the purpose of the service. They are subdivided on the basis of the type of service and anatomical site.

These include:

• Diagnostic Radiology                70000 – 76499
• Diagnostic Ultrasound   76500 – 76999
• Radiologic Guidance                 77001 – 77032
• Breast, Mammography             77051 – 77059
• Bone/Joint Studies                    77071 – 77084
• Radiation Oncology                  77261 – 77999
• Nuclear Medicine                     78000 – 79999

Interventional radiologists use certain surgical codes to signify the procedures they perform.  Some major surgical codes include the following:

• Mechanical Thrombectomy: 34201, 34421, 34490
• Biliary Drainage: 47510, 47511, 47530
• Cholecystostomy Tube Placement: 47490
• IVC Filter Placment: 37620
• Biliary Stone Removal: 47630

HCPCS Codes

Medical services and supplies that are not included in the CPT coding terminology are listed in the HCPCS (Healthcare Common Procedure Coding System procedural codes). These are represented by 1 letter (from A to V) followed by four digits. Numeric or alphanumeric modifiers can be used along with these codes to clarify a procedure.

Billing for Radiology Services

Radiological service can be billed for the physician’s work as well as the use of equipment or supplies. The technical component (TC) includes facility charges, equipment, supplies, pre-/post injection services, staff and so on. The professional component (PC) involves studying and making inferences about the radiological test and submitting a written report with the findings. Modifiers are used to signify the technical and professional components in a radiological service. They are 2-digit numbers that are used to explain a procedure in more detail. They can indicate repeat or multiple procedures, such as radiographs performed bilaterally. When billing for the technical component only, the modifier 52 has to be used; when billing only for the professional component, the modifier 26 is to be used. In the latter case, a written report by the physician providing the services is required to avoid claim denial.

Some other examples of modifiers:

• -22 – unusual (increased) procedural service
• -32 – mandated services
• -51 – multiple procedures
• -66 – surgical team
• -76 – repeat procedure by same physician
• -77 – repeat procedure by another physician
• -LT, -RT, -TA to -T9, -FA to –F9, -LC, -LD, -RC – Anatomical modifiers

The global fee comprises the total payment due for the technical and professional components and this also requires a formal written report.

Billing for Professional Component

Physicians can bill for the professional component of radiology services provided for an individual patient in all settings regardless of the specialty of the physician who performs the service. Reimbursement will be given under the fee schedule for physician services. However, for radiology services provided to hospital patients, insurance carriers reimburse the professional component only under the following conditions:

• Services should meet the fee schedule conditions
• Services provided should be identifiable, direct and discrete diagnostic or therapeutic services given to an individual patient

Payment for the Technical Component

As regards the technical component or TC of radiology services furnished to hospital patients and to Skilled Nursing Facility (SNF) inpatients during a Part A covered stay, insurance carriers might not provide reimbursement. The fiscal intermediary (FI)/AB MAC makes the payment for the administrative/supervisory services offered by the physician, as well as for the provider services. The TC of radiology services offered for inpatients in hospitals, excluding CAHs or Critical Access Hospitals are included in the FIs/AB MAC payment to hospitals. In the case of hospital outpatients, radiology and related diagnostic services are reimbursed according to the Outpatient Prospective Payment System (OPPS) to the hospital. In the case of a SNF, the radiology services offered to its inpatients will be included in the SNF Prospective Payment System (PPS). For services offered for outpatients in SNFs, billing can be made by the provider of the service or by the SNF according to arrangements made with the provider. When the billing is made by the SNF, Medicare reimburses in accordance with the Medicare Physician Fee Schedule.

Radiology Billing Standards

Radiology services can be billed in a number of ways. Some of the services are split billable and the codes for these are separately reimbursed by different providers for the professional and technical component. The physician and the facility can bill for their respective component with modifiers 26, TC or ZS. In full fee billing, the physician bills for both the professional and technical components and makes the payment due to the facility for the technical component provided. In standard billing, the facility bills for both the professional and technical components and reimburses the physician for his professional component. Services that cannot be separately billed are not individually reimbursed for the professional or technical components. These codes are reimbursed only for one provider and must not be submitted with the 26, TC or ZS modifiers.

Assigning the Codes

• Medical documentation is carefully studied to identify the radiological service performed.
• Identify the anatomical site
• Find the terms in the CPT index
• Select the codes on the basis of radiology terminology
• See whether modifiers are to be assigned

The following skills are essential for accurate coding and billing for radiology services:

• Ability to review clinical issues and CPT, ICD-9 and HCPCS coding guidelines for interventional and non-interventional radiology

• Knowledge about the differences between diagnostic radiology codes and therapeutic interventional radiology codes

• Skill to review coding guidance for modifier usage with interventional radiology procedures

• Ability to code challenging case scenarios

Professional Coding Services for Accurate Billing and Coding

When it comes to coding, the radiologist faces two main issues: first, understatement of completed treatment could mean insufficient reimbursement; second, if the codes overstate the treatment, it could result in risk of abuse, repayments and fines. Another problem is the complicated and ever-changing directives with regard to CPT procedures.

Radiologists can resolve all these issues by going in for the services of professional medical coding companies. They have skilled CPT coders to do the job. With great attention to detail, in-depth knowledge of the coding system, application of basic coding principles, and thorough documentation, these companies offer accurate, customized and affordable radiology medical billing and coding services in quick turnaround time. Most of the professional companies utilize state-of-the-art billing software to guarantee efficiency and accuracy in billing and coding, for checking local coverage determination and so on to ensure that all claims are reimbursed.

Healthcare practitioners often fail to recognize the hidden cost associated with in-house billing. This ignorance could cost them more. Very often they might not have sufficient resources and personnel to do the billing job. In such a situation, most would prefer to outsource their workload. Outsourcing medical billing services to a professional medical billing company dedicated to providing quality medical billing and coding solutions can ensure you more tangible benefits.

Here’s an overview of the benefits you stand to gain.

• Eliminates billing errors such as under pricing, under coding and missed   charges
• Allows you to focus on your medical practice instead of spending time on other functions required to run a successful healthcare unit
• Reduces paperwork which in turn increases the productivity and job satisfaction.
• Provides maximum reimbursement
• Reduces the chances of denial from insurance companies
• Provides follow-up on all rejected and denied claims
• More consistent cash flow
• Predicted and controlled billing costs
• Reduced write-offs
• Accounts receivable time is shortened
• Detailed daily, weekly and monthly reports allow you to effectively manage your healthcare practice
• No need to worry about turnover and personnel problems among the billing staff
• Eliminates overhead expenses of purchasing, upgrading and maintaining computer hardware as well as software
• Frees resources for other purposes
• Reduces labor cost
• Eliminates technical support costs
• Provides access to state-of-the-art technology
• Avoids the hassles of maintaining patient details
• Offers complete control over the financial affairs of your medical practice
• Keeps you up to date with continuously changing government regulations (HIPAA), financial conditions and technologies
• 24 X 7 customer support
• Affordable – charges based on the specialty and size of practice
• 100% accuracy on medical billing

In short, seeking the help of an experienced and professional medical billing company assures the support you need.

In the healthcare industry, it is quite challenging for physicians to manage their medical billing and associated tasks along with their most important responsibility, namely, patient care. So, outsourcing medical billing services to medical billing firms would be a good option for physicians.

Medical billing companies can accelerate the billing cycle by filing all of your claims electronically, avoiding the process of entering the patient information manually. Medical billing services help physicians by making a big difference in the way in which their healthcare facilities function.

Medical billing companies handle physicians’ billing needs including efficient patient billing, charge entry, payment posting services, claims submission, tracking of accounts, denial management, appointment scheduling and rescheduling, billing and reconciling of accounts, insurance verifications and insurance authorizations and following up of rejected claims.

Medical billing services help physicians by

• Eliminating billing headaches
• Reducing the number of denied claims
• Ensuring on time payment for all of the services they provide
• Improving office efficiency
• Maximizing medical claim reimbursement
• Improving their cash flow and profitability
• Saving resources
• Not paying more in administrative expenses
• Making them qualified for all incentives available
• Simplifying workflow

Medical billing services are available for single practitioners, small and large hospitals, dental groups, doctor’s offices, acute care facilities, long term care facilities, multi-specialty groups, and physical or mental rehabilitation facilities and more. Professionals offering these services follow HIPAA guidelines and take care to maintain strict confidentiality and privacy of all medical records.

Other benefits of using medical billing services include continuous evaluation of accounts; regular quality checks; 24/7 customer support and technical assistance; daily, weekly and monthly reports, quick turnaround and more. In short, medical billing services are a great option for physicians, which allow them to focus on their core task of patient care.

Medical Billing Services ensure compliance of The Health Insurance Portability and Accountability Act (HIPAA) of 1996. HIPAA regulation protocols are issued to protect client’s information safely. It also encourages the use of electronic processing and data transferring through multiplexer, router or modem which ensure high degree of privacy.  HIPAA has issued laws to release information confidentially. HIPAA complaint medical billing service is unique feature of medical billing company. Specialized billing procedures are:

• Insurance authorization and verification
• Cash posting and reconciliation
• Weekly or monthly evaluation
• Billing and enrollment
• Coding
• Updating anti-virus soft ware

HIPAA complaint software packages

HIPAA complaint medical billing software ensures easy way of sending electronic claims at a faster and cost effective way. It reduces claim rejection, increase collection and avoids delays. HIPAA complaint medical billing software packages include NextGen, Lytec, Misys, Medic, Medisoft, IDX and Inception. It provides a variety of functions like:

• Electronic medical billing
• Preparing patients ledger
• Processing billing information and insurance payments
• Claim submission electronically
• Rebilling of insurance claims
• Electronic medical records
• Covering patience insurance authorization
• Recording patients notes
• Medical coding
• Statement cycle billing

Hiring HIPAA Compliant Medical Billing Service

HIPAA compliant medical billing service provides track for patient statistics and diagnoses with security of health details. It provides medical billing and coding services, quick turn around time and high level of security. Those medical billing companies following HIPAA regulation protocols can assure services confidentially.  So it’s better to hire a company that strictly follows all HIPAA protocols prescribed for medical industry. Such a medical billing company reduces work load and improve cash flow.

Mounting difficulties in financial management create various administrative complexities for clinics, hospitals, physicians and healthcare facilities. Outsourcing your medical billing services to a professional medical billing company will help you to increase your reimbursements and thereby enhance business efficiency.

Tackle All Your Administrative and Financial Management Challenges

The process of medical billing entails filing, submission and following up of insurance claims. With the introduction of new technical systems such as the computer and the internet, the realm of medical billing has been undergoing rigorous changes in this modern era. For successful medical billing you need high technical support and expert medical billing professionals.

Outsourcing your medical billing tasks to a professional medical billing company can help you systematically tackle all your administrative and financial management challenges.

Reduce Your Overhead Expenses

Professional medical billing companies provide a solution-oriented medical billing service, reducing your overhead expenses. In order to provide accurate and reliable medical billing services, the companies maintain experienced medical billing specialists. A reliable medical billing firm offers services such as patient enrollment, insurance enrollment, scheduling, rescheduling, insurance verification, insurance authorization, coding process, ethical billing process, collections, AR collections, payment posting, reconciliation, following up of unpaid claims and many more.

Proper and Quality Medical Billing

For giving proper and quality medical billing solutions, professional medical billing companies utilize state-of-the-art billing systems, EMR and EPM systems. In order to ensure total convenience for clients, the companies make use of advanced medical billing software such as Medisoft, NextGen, IDX, Lytec, Misys, Medic and Inception. Professional medical billing services are distinguished by benefiting features such as:

• 100% HIPAA compliance
• Quality checking process
• Web based medical billing software
• Use of software as per the clients’ choice
• Quick turnarounds
• Free trial service
• 24/7 customer and technical support
• Anti-virus and fire wall software
• Customized medical billing
• Electronic billing
• Online reports
• Weekly and monthly reports

Deciding to outsource your medical billing services to a leading professional medical billing company is the right step to increase your reimbursements.