Any type of medical billing and coding is a complex process.
Each of these processes differs depending on the radiology procedure performed, the health insurer, and the patient. Therefore, determining the reason for repeated claim denials and then solving the problem can be a time-consuming process.
In addition, while a staff member is addressing the returned claim, new radiology claims are being neglected. This can lead to a substantial decrease or a lapse in revenue for that period of time.
Essential Radiology Billing Services
To address these issues, radiology practices experiencing repeated claim denials are turning to insourced or outsourced billing and coding services, innovative software solutions, and hiring additional radiology billers on a temporary basis.
Insourced vs. Outsourced Billing and Coding
Besides the frustration that claim denials cause, repeated denials are costly.
For this reason, many radiology practices are choosing to hire radiology billing services to handle all of their billing operations.
Insourced billing and coding keep the billing in-house; whereas, outsourced billing and coding move the practice’s billing operations to another location.
Insourced Billing and Coding
For the sake of customer service, some radiology practices prefer to keep the billers they currently have on staff, which is understandable. These practices typically choose insourced billing.
If you choose insourced billing, an experienced technician will set up Imagine Software in your office and a custom-designed training program will be created for your in-house employees. This customized program will teach your employees how to use the innovative Imagine Software.
If you go with the insourced billing option, once the seamless transition to Imagine Software is complete, your billing employees essentially become employees of your billing company.
So, for the cost of managing your own radiology billing department, you receive improved collections. In addition, you will be able to access comparables of groups across the nation.
Moreover, you know that all of your claims are now being prepared and submitted by newly-trained Imagine Software radiology billing specialists; thus, reducing the likelihood of denials and delays in payment.
Insourced billing services include:
- Claim filing and denial management
- Working claim rejections and posting payments
- Patient collections
- Ensuring the payment received coincides with the agreed-upon contract amount
- Data and reporting analytics, and analysis of carrier reimbursements
- Interface creations to the Picture Archiving and Communication System (PACS), Hospital Information System (HIS) and Radiology Information System (RIS)
- Credentialing physicians
- Working with the collection agencies and managing refunds
Insourced coding services include:
- Coding for Merit-based Incentive Payment System (MIPS)
- Working addendums, and charge audits
Outsourced Billing and Coding
If you choose to outsource your radiology coding and billing, all of your practice’s billing-related operations are handled at one of the radiology billing companies locations.
By outsourcing your coding and billing, you eliminate the need to hire employees to perform these tasks. When you take all of the costs associated with a single employee into consideration (i.e., annual salary, health insurance benefits, PTO, bonuses, etc.), fewer employees translates into substantially lower employment costs.
Outsourced billing services include:
- Claim filing and patient collections
- Managing denials and working claim rejections
- Posting payments and verifying payment amounts according to contract
- Management of refunds and credentialing of physicians
- Analyzing carrier reimbursement and working with collections agencies
- Data and reporting analytics as well as the creation of interfaces to PACS, HIS, and RIS
Coding services include:
- Charge audits and coding for MIPS
- Working addendums
With outsourcing, you improve your leverage on statement vendors, enjoy superior service, obtain insight into impactful industry trends that relate to radiology billing, attain better leverage on clearinghouses, as well as larger economies of scale.
Other Radiology Billing Services To Consider
Transition to Imagine Software
Imagine Software is an innovative revenue cycle management (RCM) automation software that is specifically designed for use in radiology billing.
Radiology practices that have experienced billing and coding personnel with excellent billing management skills should consider transitioning to Imagine Software.
Imagine Software offers a variety of options and an authorized reseller can assist you in finding the perfect fit.
Benefits of Imagine Software include:
- Custom-designed training levels for users and managers
- Radiology billing solutions are tailored to meet the needs of your practice
- Maximum collection of outstanding claims is assured through the utilization of benchmarking
If you only need assistance for a short time, you may want to hire a supplemental biller.
An additional biller is extremely beneficial if your radiology billers have fallen behind and just cannot seem to catch up. When numerous denials need to be addressed or a biller has been absent for some time, consider temporarily hiring an experienced radiology billing specialist.
A radiology billing specialist can assist with a variety of other tasks including:
- Posting payments
- Extended repayment schedules (ERS)
- Mail returns
- Reporting tasks
Choosing Radiology Billing Services
Most billing departments can benefit from ongoing radiology billing services, or even just supplemental services from time to time.
Let Dexios help you achieve exceptional billing results.