Strategies to Maximize Reimbursement for Radiology Practice

Radiology billing and coding are often considered unwieldy. It’s hard to stay up-to-date on individual payment and regulatory changes. Inconsistencies in billing and coding can lead to denial of claims. Here is a more detailed discussion of some strategies to maximize reimbursement for radiology practice.

• Use of appropriate modifiers

• Leverage payer contracts

• Better manage denials

Use proper modifiers

Incorrect modifiers are one reason for loss of reimbursement in radiology practices. When filing the claim, physicians should mention where the radiology service was provided, who owns the equipment as a modifier. 26, TC, 76, 77, 50, LT, RT are some of the modifiers used in radiology medical billing.

• 26 – Professional component: This modifier is used when physicians supervise and interpret a diagnostic test and write reports.

• TC – Technical component – This modifier covers the cost of non-professional personnel, types of equipment and components.

• 76 modifiers used when service is re-rendered on the same date of service by the same physician.

• 77 modifiers used when service is re-provided on the same date of service by different physicians.

• LT / RT modifiers used when imaging one side of the body.

Leverage payer contracts

Image utilization is managed by private payers through RBM (Radiology Benefits Manager). Requires pre-authorization processes. RBMs help get more evidence passed and avoid unapproved evidence that may not be reimbursed or become self-paid evidence that can be progressively difficult to charge for providing.

With paid recruitment increasingly requiring radiology groups to work with GBR, skill over payment trends, proper coding, and testing not deemed medically necessary will be essential to ensure facilities receive accurate reimbursement. for their services.

Better manage denials

Insurance claim denials are one of the biggest obstacles to health care reimbursements. For better handling of claim denial, first, find out and analyze denials and the reasons for denial. Claims are resubmitted with corrections to payment. Improved claim denial management strategies maximize health care revenue and reimbursements.

Outsourcing

To maximize your radiology practice reimbursement, medical billing outsourcing is the best option for a radiology practice. Medical billing experts are always kept up-to-date with changes in regulations and are proficient with the billing and coding proficiency required for radiology billing. About e-care

e-care is the leading medical billing outsourcing company in India. We provide various medical billing services such as radiology medical billing services, cardiology billing services, anesthesia billing services, revenue cycle management services. To learn more about medical billing and coding services, please log in to our website: http://www.ecareindia.com