Radiology is a high-volume specialty, and as you can image accurate coding is critical. If you think about the massive number of medical records and documents your radiology staff have to read and interpret, you understand why they want billing processes and reports that are quick and to the point. An experienced radiology coder understands the critical pieces of documentation needed to assign procedure codes to ensure physicians and their practice make as most money as they can. That's why we have billing experts, right? Better radiology billing knowledge = better bottom lines.
In addition, radiology billing personnel and coders review documents from the requesting physician to ensure the records meets medical necessity, and to make certain what the referring physician ordered was what was actually performed. Many practices utilize technicians to check-off codes on charge tickets, which may contain obsolete procedure, and diagnosis codes. Often coders will work with physicians, technicians, and administrators on updating charge masters, as well as educating the radiology staff on the specifics of codes.
If you're looking for ways to make your radiology billing more efficient or profitable, this blog can help. Below are some radiology billing tips to help get you started ...
1. Establish a Collaborative Partnership with Revenue Cycle Management Company
With healthcare costs rising and codes changing, operating margins are under close scrutiny and practices are looking for strategies to help them increase profitability. A partnership with a reputable Revenue Cycle Management company who specializes in radiology billing, will deliver increased results from your practice's billing. Their medical coders will strengthen your radiology practice's revenue stream by reviewing documentation, selection proper codes submitting, submitting clean and accurate claims which can undoubtedly speed up and maximize reimbursement and compliance.
For example, all HIS Coders are certified and credentialed and must pass a monthly audit of 95% or better. Our team of experts are required to follow all coding industry standards and are audited according to OIG guidelines. So, our advice is - be wise with whom you partner. Better safe than sorry.
2. Make Education a Priority
While you don’t have to have radiology specific credentials in order to code radiology, coders must be certified and maintain their credentials. Best practice requires coders to become credentialed after two years, which is the normal time span for a coding apprentice. If you do employ and in-house billing team, ensure they are up to date and maintaining coding education. If you outsource billing, check into your partner’s credentials and certifications.
AHIMA touches on the importance of this saying, "With audits such as Recovery Audit Contractors (RACs) and Comprehensive Error Rate Testing (CERTs) becoming a part of standard processes, radiology billing staff need to be aware of the verbiage needed to describe the exams performed. Knowing the correct verbiage will help to eliminate costly appeals or having to provide additional information long after the original date of service.
3. Implement Audit and Compliance Programs
A strong audit and compliance program will ensure your billing staff and/or company follow accurate coding procedures. Accurate radiology coding translates into clean radiology claims which produce faster payments and higher reimbursements, along with fewer denied claims, appeals, and claim re-submissions. Catching errors before the claim is submitted is vital to a high clean claims rate. In addition to the compliance and auditing process, an accurate and complete charge capture strategy must be in place. Charge capture is an essential component to reimbursement and is continuously monitored.
At HIS, we have a multi-faceted, thorough approach to ensuring complete charge capture. Radiology is a specialty with unique aspects that require technical and medical expertise – whether it is for your staff or from a partner who handles the management of your revenue cycle. Having a team with the experience and knowledge to strengthen your revenue stream and improve your radiology billing process, provides your radiology practice a competitive advantage.
What are some of the radiology billing practices you follow? What are radiology billing questions or issues you’re having? Comment below – we’d love to help!