Imaging center billing is considered one of the most subtle and intricate aspects of the medical billing process. Whether it is a complex MRI or a simple X-ray, each procedure has two separate components which are called technical and professional components. So, understanding how you can accurately identify and bill for these components can create a huge difference in your revenue cycle. Always remember that for imaging centers; knowing these differences is the key to the proper imaging center billing process.
Understanding both Professional and Technical Components
The technical component is the cost for the equipment, staff, and materials used to perform the scan. For instance, the imaging centers owning the MRI medicines may bill the technical components to provide the scan. On the other hand, the professional component is where the physician interprets the imaging study and prepares reports. If the reading physician is not contracted in a way that allows global billing, the radiologist bills the professional component, while the imaging center bills the technical component. However, when the insurer bills these components, global billing happens which combines the technical and professional charges in a single claim.
What Role Global Billing Plays?
Global billing is used to simplify a claim where an insurer provides both professional and technical components. It is very common in integrated outpatient clinics or hospital-based imaging centers. Global billing can make the administrative process easier but only in that case where the procedures are performed under a contractual agreement. The independent billing is only possible when the imaging center owns the equipment. The payers thoroughly review these claims and if they identify any tiny issues, then it can lead to audits.
The Reason for Billing Errors
The well-experienced billing staff also face several errors when they handle the imaging center billing. The errors include misusing the wrong modifiers, duplicate billing for identical service, referring the provider documentation with the billed service and interpreting radiologists. These tiny errors can lead to non-compliance, claim denial, and delayed payment. Hence, accurate documentation and coordinated communication amongst the billing and radiology department is important to avoid these issues.
How the Radiology Billing Solutions Help?
There are several ways in which radiology billing companies help, starting from staying updated with the latest regulations to using the right technology. All these ways are described below:
1) Staying Current with the Latest Regulations
Healthcare regulations change constantly because new diseases come every day. So, it becomes difficult for the healthcare staff to focus on these along with patient care. Here, the radiology billing services come who stay updated with all the latest CPT, ICD and HCPCS codes to make sure no claim denial occurs. Apart from that, they also know all the complex nuances of the HIPAA law to protect patient data.
2) Knowing the Complex Nuances of the PA Process
Prior authorization is a complex and time-consuming affair. It is because you first need to verify the patient’s insurance eligibility, collect important documents, and submit the PA request to streamline claim submission. But as the healthcare staff focus on patient care, that’s why they cannot focus on also the administrative tasks at the same time. Here, the imaging centers billing experts come who knows all the ins and outs of the PA process.
3) Cost-effectiveness
The in-house staff come at a high cost because you need to train them and also buy expensive office space for them. Hence, it will increase a lot of costs for clinics. On the contrary, the radiology billing outsourcing company has dedicated experts who are previously trained, and they don’t need any separate office space. Hence, with their help, you can reduce your healthcare costs to a large extent.
4) Technology-agnostic
Technology plays an essential role in streamlining the claim submission process. Always remember that manual process not only is highly error-prone but also it takes a lot of time to perform. Here, the outsourced experts come who know how to work with the clinic’s EHR system to store patient data. Furthermore, they also know the working process of the Electronic Prior Authorization (EPA) procedure to submit claims electronically.
5) Taking the Help of Radiology Billing Solutions
As there are so many companies out there, how can you choose the right expert for your clinic? They help you with customized reporting and weekly share of reports according to your protocols. Moreover, they have a free transition process and can reduce your operational costs by 80%. These services have a quick turnaround time of less than two days and provide the best infrastructure setup according to the client’s needs. These companies also provide dedicated account managers at no extra cost and no restrictive clause or binding contract.
It has been observed that these companies have dedicated employees having US phone numbers and working in real-time. Moreover, they also have free account supervisors, account and IT infrastructure setup at no extra cost. Furthermore, these services also provide real-time audits and custom reporting. They also provide real-time eligibility checks and quicker authorization. In addition to that, they are 100% HIPAA-HITECH compliant and have less service fees with no hidden cost. These services also provide 360 degree revenue cycle management services and follow a specific medical coding process flow. So, if you want to streamline your billing process, it may be a feasible option to outsource radiology billing services in that matter. Hence, take the step today and see the difference.
