Wondering what’s holding you back from acquiring a perfect clean claims rate and adequate revenue? Claim denials are a leading cause of inefficiencies in radiology medical billing. If you want to achieve profitability, you must find ways to block denials.
Denials impact your operational flow and prevent your practice from achieving profitability.
In the case of radiology medical billing, simplifying the overall process and trying to reduce claim denials as much as possible is extremely necessary. But before jumping to conclusions, you must identify what’s causing denials in your practice. This way you will be able to rectify the challenges and prevent claim denials.
So, let’s start this blog and learn about the top reasons behind radiology billing claim denials and how you can address them.
Main Reasons Behind Claim Denials in Radiology Medical Billing
Insurance Eligibility Mistakes
Checking insurance eligibility verification is essential to ensure the patient has necessary medical coverage for radiology procedures. Mistakes during this step are a common reason behind claim denials.
During this step, healthcare providers must examine the insurance policy and confirm if the patient’s coverage is updated and other details are correct. Ignoring small details may result in rejected claims and income loss.
Corrective Actions
The first step of insurance eligibility verification is crucial, and you can improve it simply by following a thorough assessment process. Otherwise, you can hire professionals to handle this critical task efficiently. By outsourcing radiology billing services, you can elevate your billing process and face complexities with ease.
Prior Authorization Delays
Prior authorization delays can impact the entire revenue cycle management of your healthcare practice. Before offering your radiology medical services, you must get authorization from the insurance provider. Once approved by the payer, treatment costs are confirmed to be covered by insurance.
On the other hand, lack of prior authorization leads to claim denials and disruptions in the financial flow of the practice.
Corrective Actions
Taking prior authorization seriously is the first step towards ensuring that it is achieved. You can designate this task to a specific team that does everything regarding approval. The most important part is writing the approval numbers without any errors, and an expert team can do it for you.
Inaccuracy in Medical Coding
When healthcare providers talk about medical billing complexities, they never miss this major challenge. And it is medical coding and errors in coding that affect revenue cycle management. The CPT codes for radiology are very specific and prone to mistakes if not handled properly. Accurate codes are a must for a higher clean claims rate and reduction in claim denials.
Corrective Actions
Enhancing coding accuracy is incomplete without qualified coders who know exactly how to handle your radiology medical coding. The ideal way to have certified coders work for you is by partnering with a medical billing services company in Arizona.
Insufficient Medical Documentation
Documentation must not be overlooked in any circumstance, as it plays a key role in ensuring overall radiology medical billing accuracy. Documentation is basically the proof of patient treatment and important records regarding medical necessity and other radiology procedures.
Improper documentation causes errors at the time of medical coding and leads to an increase in the number of claim denials.
Corrective Actions
To ensure that your practice follows documentation steps with precision, you must lay out an effective framework for recording every detail. Outsourcing radiology billing services reduces the hassle of handling vital steps like documentation while implementing authenticity.
Late Claim Submissions
While understanding each step in detail, you cannot miss submission of claims. The timing of submission is significantly important in streamlining the medical billing process and reducing denials. Late submissions are equally detrimental to radiology medical billing as any other step.
Corrective Actions
Healthcare providers must realize the need to submit claims on time and prevent denials. Setting reminders and utilizing technological tools are some reliable ways to accelerate the submission process. Working with a medical billing services company in Arizona is another corrective action that you can take for your healthcare practice.
CPT Bundling Rules and Compliance
Radiology is a complex medical specialty requiring expert knowledge and skill during coding and compliance. Without appropriate courses of action, healthcare providers can fail to follow CPT bundling rules and compliance.
Corrective Actions
If you want your radiology practice to function smoothly in terms of CPT rules and compliance, then you must focus on staying up to date. Also, you must incorporate regular audits and thorough checks to avoid such mistakes.
The Role of Medical Billing Services Company in Arizona
Radiology medical billing can be complex, but it must not be something that stops your practice from achieving adequate revenue. And this is the role of medical billing services: to offer perfect administrative outcomes. Whether you want to simplify the operational flow or handle patient inflow effectively, outsourcing radiology billing services can help you.
Uplifting your revenue cycle management is a process, and a medical billing company can do that without any hassle. Other than improving medical billing steps, your outsourcing partner also offers
Complete Transparency
Medical billing services offer a wide range of services for different medical specialties. When it comes to handling your medical billing process, they provide clear communication and stay transparent throughout the course.
Affordable Medical Billing
Outsourcing radiology billing services is more affordable than maintaining your personal medical billing staff. When a third party handles your administrative process, you don’t need any investment in infrastructure, staff salaries, or more. You only have to shift your burden to the professionals, and they will handle the rest.
Usage of Suitable Technology
Medical Billing Partners is well-versed in the usage of technology to reinforce accuracy and efficiency. They utilize the appropriate medical billing tools to reduce manual errors, optimize medical coding, and prevent submission delays.
HIPAA Compliance
HIPAA compliance is a vital standard, and every healthcare provider and practice must comply with it. It protects sensitive patient information from unauthorized use. By following HIPAA requirements, medical billing partners safeguard healthcare providers from legal action, monetary loss, and reputational damage.
Denial Resolution Process
Medical billing services recognize the importance of resolving claim denials and preventing revenue losses. That is why they follow a proper denial management process that aims at finding the root cause of denials and preventing them, refiling denied claims, and recovering the lost revenue.
A medical billing services company in Arizona is what you need to solve administrative issues and achieve financial stability.
Final Thoughts
Eminence RCM is the medical billing company you are looking for outsourcing radiology billing services. We have a well-trained and experienced billing and coding staff who will take care of your radiology medical billing.
From the first step to receiving reimbursement, we are ready to deal with complexities and help you. With our skill and knowledge, your radiology practice will thrive in every administrative aspect.
Resolve your claim denials conveniently with us, reduce errors, prevent delays, forget the stress, and boost your bottom line with Eminence RCM.
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