Unique Challenges Facing Radiology Practices and How Medical Billing Services Help

Unique Challenges Facing Radiology Practices and How Medical Billing Services Help

Radiology medical billing and coding services help radiology practices deal with their new challenges and falling reimbursement.

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While playing a key role in diagnosing many diseases as well as in monitoring treatment and predicting outcome, radiologists need to be experts in image capture technology and managing IT applications for healthcare. Ensuring appropriate reimbursement is a challenge as imaging services are now intensely scrutinized by public and private payers. In this unique scenario, radiology medical billing and coding services are proving of great help for practices to stay viable.

Recent Changes impacting Radiology Practices 

Coding revisions: The Centers for Medicare & Medicaid Services (CMS) and National Correct Coding Initiative (NCCI) have made certain coding revisions this year. CMS has altered its coding policies for low-dose CT lung cancer screenings of current smokers with an implementation date of July 5, 2016. NCCI has also made code corrections to radiotherapy planning procedures and the calculation of basic dosimetry.

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Increasing use of data analytics: Industry experts point out that data analytics will drive medical imaging facilities. Big data and workflow informatics technologies help imaging facilities deliver more value and operate more efficiently and productively.

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Value-based payments: With falling reimbursements and increasing business costs, more and more radiologists are participating in the Physician Quality Reporting System (PQRS) as a way to make up for lost revenues. The American College of Radiology reports that though the number of radiologists who successfully qualified for incentives under PQRS increased each year, an estimated 76.3 percent of radiologists would be subject to mean penalties of at least $2,654 in 2016. To get the bonus under PQRS, reporting successfully on at least three measures per physician is necessary.

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Managing switch of IT systems: It is found that radiology practices that change their IT systems face many data migration complications. They need work with the IT system vendor to chart a realistic migration schedule, establish contingency plans, and ensure that the database cleanup will be executed properly.

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Improve workflow management: consolidation in healthcare and the need for efficiency is driving workflow orchestration in the imaging informatics arena. As more

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and more radiologists work in larger groups, the need of the hour is the use of advanced software to improve workload management and service.

How Outsourcing Medical Billing Helps A recent article published by the Radiological Society of North America reported that during the last decade, imaging utilization has increased without corresponding increase in payment, resulting in an increasing gap between productivity and reimbursement. The author identifies the unique stressors that have led to physician burnout as increase in the number of bureaucratic tasks, too many work hours, and increasing computerization.

Partnering with a radiology medical billing company would help these specialists resolve many of these challenges. These companies have experts who are well-versed in diagnostic radiology coding and payer rules, and will use the correct codes to submit accurate claims.

By ensuring proper billing procedures and reporting add-on codes that are relevant to the PQRS measures, they can also help radiologists achieve PQRS success. Professional radiology medical billing service covers everything from patient eligibility verification to claim submission and payment collection.

www.outsourcestrategies.com

Phone: 1-800-670-2809