3 Tips to Improve Radiology Billing

Improve Radiology Billing

Being able to improve radiology billing is a priority for every practice to help maximize reimbursements, however, it gets more difficult every day for several reasons – insurance companies change their rules and parameters, patient costs and co-payments continue to rise, growing audits, etc. 

With this in mind, here are 3 tips to help you improve your radiology billing:

  1. Make Sure All Patient Information is Up-to-Date

It’s critical that office-based practices collect and verify patient demographics, including name, address, phone, social security number, insurance, guarantor, etc. every chance they get. To that extent, it’s important to effectively train employees to ask questions like:

  • “Has any personal information changed?”
  • “Has your employment situation changed recently?”
  • “How long since your last medical appointment?”

An effective way to drill on the importance of collecting this information is to illustrate how much extra work is needed if any of the information is incorrect. 

For hospital-based practices, scheduling periodic meetings with hospital executives is a good rule of thumb for capturing the demographics and making sure the data is complete. 

Whether office or hospital-based, if technology is in place, insist on eligibility checking as early into the process as possible. Offices should do this after scheduling in order to see the patient status. Hospitals should perform these checks after registration. 

  1. Measure and Follow-up on Denials Aggressively

Another way to improve radiology billing is to keep a close eye on the denials rate. While most claims are paid the first time they are filed, some are not – and that percentage can be a problem. By monitoring the denials rate, (or “first pass denial rate”), this indicates how effective a practice’s upfront process is and how well its billing edits and checks are performing.

As denials occur, it’s important to have processes in place for resolving them and submitting an appeal. Unfortunately, it’s frequent practice for billing staff to refile the claim, but this is not an effective process. Having this process in place is what separates good billing results from mediocre. A second denial measure is used to monitor the percentage of charges that are denied and never paid (percentage should be in the single digits). 

  1. Keep an Eye on Rising Patient Balances

Higher deductible insurance plans and co-pays are on the rise, putting more fiscal responsibility on patients. Not every dollar will be coming from insurance companies, so it’s important to closely monitor how much patients owe while “treating” patients with care. Here are some practical ideas:

  • Automate Follow-up and Make Billing Easy for Patients – Patient billing usually happens after the insurance payment is received. Put in place workflows to ensure confirmation of payment through automated second statements 30 days after the first, set up phone call reminders, and/or offer a secure online portal so payments can be made via credit card. 
  • Collect Co-payments Before Visit – Before patient billing even begins, collect co-pays ahead of the visit. This again goes with training the receptionists and front desk staff to make this part of the check-in process. It’s not always easy to ask for money, so frame this as a question like “How would you like to pay your co-pay?” rather than “would you like to pay your co-pay?” 
  • Eligibility Checks & Escalations – Most insurance companies will provide the patient’s deductible or co-insurance, so front desk employees have an exact dollar amount to ask for. Additionally, practices are fully within their rights to ask for part or the full amount. At a minimum, ask for a credit card to keep on file that can be charged after insurance has been processed. Finally, make sure to have a process in place where there’s an individual to handle any escalations. Payments can be a sensitive topic, but it’s important that practices collect as much of what is owed to them as possible before the patient goes through his or her appointment. 

Want to learn more about how to improve radiology billing? Download our “3 Tips to Improve Your Billing” white paper, get in touch with an AdvantEdge expert, or stay up to date on company and industry trends by visiting our LinkedIn page