During recent years, radiology-related technology is going through a lot of improvement and practitioners are now more into control and can provide better services but the necessary high-tech equipment and supplies involved have caused the cost of the service to rise. The private insurance companies and federal programs are looking to cut the costs they need to cover. Eventually causing problems for radiology practitioners.
The transition from fee according to service to bundled payment has become more complex due to various policies and practices with accountable care organizations and value-based models and pay-for-performance.
In hospitals and other small facilities, the radiology department generates the highest profit as being responsible for only 37% of the profit on average. So it is important to get payments out of the insurers and other payers in a timely manner.
Claims denials often occur when errors are made in billing and coding. Payers do not take time to consider whether the error is insignificant or not. Even in some cases, a missing hyphen can cause rejection of claims. Payers even deny a number of claims when there are errors in submissions. Each claim evaluation and resubmission takes a lot of time and increases labor costs too. We do not take claims for granted and focus on each and every claim and submit error-less claims. If any claim still gets rejected, we take full responsibility, correct errors, and resubmit them.
Some of the time, problems with claims arises and catch the attention of in-house staff. The problem states that the patients complain about being billed for charges that they weren’t expecting. This not just only require more staff time to handle but also patients feel their trust has been breached. On the other hand, payers also have requirements for claims. This means that claims need to be timely managed and need all the back and forth trying to get the claims submitted correctly still can result in missing a deadline.
Eligibility Issues: stating the wrong service, noting the wrong insurer’s plan or plan number are a common examples of patient’s insurance eligibility issues.
Authorization Failure: authorization failure for claims reimbursements.
Documentation: Improper documentation stating medical necessity reimbursements.
A lot of claims that get rejected are because of small human errors. As per all the complexities involved in payer’s rules and regulation, annual changes in coding and billing makes it impossible for a busy facility like radiology to focus and stay on top of it and avoid errors. The best solution is to outsource “””” so that you can give more time and attention to your services without worrying about financial issues that come up because of medical billing.
Our company the ‘’’’’’ covers all the phases of medical revenue cycle management. From pre-appointment to aging due accounts receivable we have you covered. We have departments of specialists that can handle every issue and claim effectively and as we provide billing services, we make sure we stay up-to-date on every medical and coding revision that come up. Also, the software that we use are modern and are updated to every medical coding updates.
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Medical Coder company always billed a healthy and trustable relation with his clients. Our trained and well experienced staff objective is to give 100% results as per our customers demand. Our main focus is customer satisfaction.