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Our team consists of certified professional coders (CPC) and billers (CPB) who are fully aware of the complexities of radiology medical billing. The AAPC-certified experts submit clean claims electronically to the clearinghouse, minimizing errors and maximizing first-pass acceptance rates. Here’s how they do it for you:
- Integrate Electronic Medical Records (EMR), Electronic Health Records (EHR), Electronic Data Interchange (EDI), and Practice Management Systems (PMS) with radiology-specific billing software to facilitate electronic claims processing and electronic payment processing.
- Gather patient demographics (medical history, physician referrals) and insurance details (coverage upfront, preauthorization requirements, effective dates, expiration dates, claims addresses) to verify eligibility for claims processing.
- Delegate professionals with niche expertise in value-based billing, telemedicine billing, capitation billing, and episode-of-care billing processes.
- Segregate bills as per radiology cost components such as technical components (TC), professional components (PC), and global billing.
- Pay particular attention to using the correct radiology CPT code, ICD-10 code, HCPCS Level II codes, modifiers, and Dx-codes. The assigned codes are evaluated for quality to ensure accurate reporting of imaging procedures, proper documentation, adherence to radiology coding guidelines, etc.
- Align with the American Medical Association (AMA)-specified 70010-79999 code range for radiology procedures to handle the proposed changes and continue to provide top-notch services.
- Cover billing for interventional radiology procedures (X-rays, CT scans, and MRI), radiation oncology treatments (external beam radiation therapy, brachytherapy, and stereotactic radiosurgery), diagnostic imaging, nuclear medicine, cardiology procedures, and more.
- Align with the guidelines of Medicare, Medicaid, workers' compensation insurance, Tricare, other private insurance payers like Humana, Aetna, etc, and fee schedules relevant to each entity to ensure zero-error claims file documentation.
- Identify and address any contractual adjustments required by your payer agreements.
- Obtain EOBs from the insurance payers to verify any uncovered services or disputes. If any, we resolve it and initiate the appeals process.
- Generate transparent reports detailing charges, allowed amounts, deductibles, co-payments, and co-insurance for each patient with the help of EOB. Notify patients about their payment responsibilities to prevent unpaid claims.
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