9 Critical Radiology Billing Steps for Your Practice

A flawlessly processed claim accelerates payment timelines significantly, but even a minor error can disrupt the payment flow, resulting in inconsistency. Hence, partnering with radiology billing experts becomes imperative to ensure smooth RCM execution.?

Just as any business requires rigorous adherence to certain radiology billing practices to maintain smooth operations and foster growth, the Medical Billing process is no exception.?

Below are 9 radiology billing Steps, if followed efficiently, it can reap better revenue generation.?

1. Patient Registration: Typically conducted for new patients, during which we gather personal details including age, gender, address, and contact number, alongside insurance information such as policy ID and provider name. We strongly recommend a brief verification each time a patient revisits the office. This practice ensures data accuracy, keeping the system updated, crucial for claim documentation. Any inaccuracies may result in claim denial or rejection, further delaying payment processing.??

2. Insurance Verification: Before rendering services, confirming the insurance policy's active status, coverage for services, and any authorization requirements is crucial. This verification aids in determining payment responsibility. While insurance websites typically offer this information, details obtained through phone verification can serve as valuable evidence in case of claim denials.??

3. Encounter: A term referring to the meeting between the patient and provider, during which the patient discusses their issue and the provider evaluates their condition to inform treatment decisions. This interaction is often recorded via audio or video technology. Ensuring accurate capture of details and thorough recording of the session facilitates precise claim preparation.??

4. Medical Transcription: Skilled radiology billing professionals listen to recorded sessions and transcribe information into medical documents, crucial for maintaining accurate patient health records. This process must be error-free as these documents are utilized in future follow-ups and by providers for patient care. Any inaccuracies could compromise patient medical history, leading to erroneous decision-making. Additionally, these documents are utilized for radiology? billing purposes, and any errors may impact claims.??

5. Medical Coding: Following American Medical Association guidelines, a team of professionals analyzes recorded documents and translates pertinent information such as service locations, reason for visit, and treatment measures into numeric or alphanumeric codes. This practice is essential for clarity and is a mandatory requirement.??

6. Charge Entry: The expenses incurred for services provided, or the maximum collectible amount, are added to charges coded by the coding team. This step is crucial for preparing claim forms submitted to insurance companies. Accurate entry of charges is monitored closely, as errors could result in reduced claim payments.??

7. Denial Management: Insurance companies adhere to specified time limits for processing claims. Upon acceptance, claims undergo adjudication, wherein insurers assess their validity and decide on payment. Occasionally, partial payment may occur alongside denial of remaining charges. Professionals overseeing denials prioritize claims nearing submission deadlines and outstanding amounts to maximize revenue. They analyze denial trends, implementing corrective actions to prevent future denials.?

8. Account Receivables: Radiology billing professionals manage claims denied by insurers despite corrective measures. They conduct thorough follow-ups with insurers, gathering denial-related information, investigating, and coordinating to sustain payment flow. Correct data is shared with teams like Insurance Verification, Coding, and Charge Posting for future claims. Additionally, they handle correspondence with insurers.?

9. Payment posting: Once you receive the green light from the insurance company, they will send you the payment by paper checks or electronic transfers. Insurance companies usually send payments in batches.???

Sunknowledge offers comprehensive radiology billing services at budget-friendly rates to healthcare providers across the nation. The list above outlines the top ten tasks in the healthcare revenue cycle. Additional tasks like payment reconciliation, patient statements, and financial reporting stem from this process. Ensuring accurate data entry and proactive follow-up with payers are vital for optimal financial performance in any radiology practice.?