What Makes Radiology Medical Billing Difficult?

Radiologists need to be experts in diagnosing several ailments and monitoring the treatment, and predicting the outcome; besides that, these experts play a crucial role in managing the IT applications for healthcare. It is pretty challenging to ensure appropriate reimbursement as public, and private payers mainly scrutinize the imaging services. Radiology Medical Billing and coding is often considered cumbersome by most practitioners because it is quite tough to stay up-to-date on the individual payer changes and regulation changes. In hectic environments, billing and coding inconsistencies are not unusual.

There is always a chance of having compliance issues due to this, plus there might be lost charges or under-coded charges. Usually, the majority of errors are only found when claims are disputed, or audits are performed. Both medical billing and coding services play a crucial role in order to stay viable.

Some of the latest changes that are impacting radiology services are as follows:

• Coding Provisions and Revisions

National Correct Coding Initiative (NCCI) and The Centers for Medicare and Medicaid Services (CMS) have made some revisions regarding coding and altered the coding policies. NCCI has made code corrections for radiotherapy planning procedures, while the CMS has brought alterations in coding practices for low-dose CT lung cancer screenings.

• The Boom in Data Analytics

The experts from the industry tend to point to data analytics that are driving the medical facilities currently. Big data and workflow analytics help drive more value which ensures the process moves more efficiently and in a streamlined manner.

• Value-Based Payments

A plethora of radiologists participate in the physician quality reporting system thanks to the falling reimbursements and ever-increasing business expenses. Every year, the incentives under PQRS tend to increase. If one wants to get a bonus under this system, then reporting successfully on three measures per physician is mandatory.

The American College of Radiology says that even though the numbers of radiologists who have successfully qualified for incentives under the PQRS have increased each year, approximately 76.3% of radiologists paid approximately penalties that amounted to $2,654 in the year 2016.

• Managing the Swift in IT systems

It is known that radiology practices tend to change the IT systems that face several data migration complications. They have to work under the IT system vendor to get a realistic migration schedule and make contingency plans. Above all, one needs to ensure that cleanup is executed accurately.

• Improve the Workflow Management

The driving workflow of the orchestration in the imagining informatics arena is the consolidation in the healthcare sector as several radiologists are working in larger groups.

Ideally, radiologists are under increased monitoring for billing errors and irregularities. An article published by the Radiological Society of North America has reported that imaging utilization has increased manifold in the last decade without a corresponding increase in payment. This resulted in increasing the gap between reimbursement and productivity.

Conclusion Thus, outsourcing radiology billing services would help them resolve many of the issues listed above and streamline their crucial activities for the radiology practitioners. 24/7 Medical Billing Services is a reputed company with a decade-long experience in providing revenue cycle management and medical billing services. By outsourcing the radiology medical billing services, one can be rest assured that all the diagnostic radiology coding and payer rules and procedures will be followed. The correct codes to submit accurate claims and the reporting add-on codes for PQRS measures will be followed, which will help radiologists achieve targeted PQRS success.

Read More: How Outsourcing Radiology Billing Can Help You in Enhancing your AR?