For radiologists all over the United States, the medical billing and coding process is often viewed as burdensome. Most times it is difficult to remain up to-date on all the billing regulations and individual payer changes, with no time to understand them. But, it’s imperative for the radiology practice to thrive.
Gradually more radiologists are taking the outsourcing way to increase their income. However, even when radiologists’ outsource their medical billing accountabilities, it’s still essential for them to be aware of what they can do to help the processes and improve their financial outcomes.
Here are some important tips to help radiologists keep their billing and coding processes in check, so as to receive the reimbursement they are entitled to and keep their concentration on their passion, which is radiology.
Observe medical necessity and check for Advanced Beneficiary Notices (ABNs) on Medicare
When a particular service is not covered by Medicare due to lack of necessity and ABN should be provided to the patient. This covers the facility technical component and professional component fee. The vital component which is the ABN is frequently missed due to the assistance needed from the staff at the facility staff as well.
A radiologist should work with the billing facility staff at the patient’s hospital to ensure the ABN also lists the professional component fee. Along with this, the radiologist should ask their billing company to check the trends from ordering physicians. These physicians also need to be aware of the Medicare covered conditions before jotting down the codes for a specific service. Further, the radiologists should coordinate with their partnering billing company to receive a copy of the signed ABN from the patient. This coordination may seem tough on the outset, but once a process is put in place, radiologists will experience a rise in revenue and less patient write-offs.
Analyze templates and titles
Because of the high volume of exams conducted each day, most radiologists create templates to make sure all applicable documentation is addressed. These templates should be analyzed at a minimum annually with the related CPT updates to ensure they are current. If the group modifies equipment, a technique we as experts in radiology billing recommend auditing the templates when changes occur.
For example, when the radiologist are using analog equipment and now uses digital mammography equipment, the reflected change needs to be updated on the template.
Communication with your billing company is must
When you are working with an outsourced radiology medical billing company like Medisys – a leading medical billing company and a change in equipment and techniques occurs, the facility needs to notify your billing company. When this happens the radiologists should review and update the templates as discussed above. Now when the billing company is aware of the change, they just implement it in their coding modifiers. Ultimately, the radiology practice is responsible for the all the updates surrounding their specialty, however the billing company can also double check for accuracy and updates.