A well-managed billing process with dedicated billing staff can ensure cleaner claim submission increasing claims first-pass rate and reducing denials, which is the goal for any Medical Practice. Radiology Billing is a vast process mostly handled in high volume. With such a high volume of claims processed, even by the experienced billers and coders, eliminating claim denials can seem inevitable; however, denial percentage can be controlled with conscious efforts while approaching Radiology Billing. Discussed below are few tips to avoid Radiology Claims Denials.
Radiology Practices should aim towards keeping their claim denials within agreeable percentages and increased reimbursement. Let us look into the denial reason in Radiology Medical Billing and analyze how to curb them.
There are many factors leading to denials while billing radiology claims. Cautious efforts by all billing and coding staff involved play a vital role in declining the denial percentage to achieve internal quality standards.
Few common denial reasons are:
- Incorrect or Incomplete Demographic details
- Coding error
- Modifiers missing/incorrect
- Missed Prior Authorization
- Coverage Eligibility and Benefits verification not done
- Charges inconsistent to Procedure code
- Incorrect Place of Service
- Timely Filing Limit exceeded
- Claim paid by Secondary Insurance
Cleaner Claims Submission for consistent Billing Quality
To ensure cleaner claim submission in Radiology Billing, Practices must have a strategical and streamlined billing process in place and ensure the above mentioned reasons for denial are possibly curbed. In addition to having a streamlined billing process and experienced team, it is also quintessential to have a regular internal claims audit function.
With regular audits on analyzing the billing pitfalls and common denial reasons help members involved to correct them thereby controlling further such denials.
Setting up all mandatory requirements right from staffing to upgraded tools to approach Radiology Billing will fetch targeted success and cash flow. Listed below are few tips to be worked on while processing Radiology Billing to ensure claim denials are under control.
- Effective Insurance Eligibility and Benefit Verification
- Obtaining Prior Authorization and Referrals
- Staffing Dedicated billing and coding team
- Timely Denial Management and AR Follow-up
- Streamlines Billing Process
- Following updates and changes in coding guidelines
- Following client specific guidelines
- Investing in artificial intelligence and upgraded tools for claims processing
Billing Support and Partnership
For any practice with primary focus towards patient care can find the billing process taking a backseat comparatively, nonetheless, understanding the business goals and revenue targets to be achieved will emphasis the need and importance of quality billing. A Medical Billing Company with more than 2 decades in the industry and servicing a vast number of clients for radiology billing will be able to provide ideal solutions to all your billing needs. Partnering with such a well-established Medical Billing company can be the best choice for your Radiology Practice.
About MGSI
MGSI – National Medical Billing Company located in Tampa, FL has been providing complete Revenue Cycle Management Solutions for more than 25 years. MGSI is a multi-specialty Medical Billing Company and Radiology is one of the top services with a huge clientele. With AAPC certified coders and experienced billers, MGSI can provide ceaseless services for Radiology and Imaging centers. Partnering with MGSI guarantees 95% first-pass rate with 96% claims paid within 30 days. Is your practice struggling with Denials, reach out to MGSI at 1-877-896-6474 or log on to www.mgsionline.com