Even if you are radiology practice that has already outsource your billing priorities. It is still important for you to be well aware of the processes and constantly improve to become more secure with your reimbursements to help you with better financial outcomes in today’s billing scenario.
Here are some of the salient guides that will help you to receive payment that you are entitled to. Also, it will help you focus on your core priorities, providing best in class radiology services.
Monitoring the medical necessity and also asking for the advanced beneficiary notes (ABN) on the Medicare patients should be a top consideration. In radiology billing, it is important for you to lay down the right checks and balances.
If a service is not covered by the Medicare as there is lack of medical necessity, an ABN must be provided to the patients. The ABN will cover the professional and technical component fee. A radiologist has to work with the facility staff to ensure that the ABN also lists the professional component fee. A radiologist should also coordinate with the billing extension so that they receive the signed ABN from the patient.
Also it is important for you to stay ahead with the required dictation process. As the audits such as the RAC’s and CERT’s becoming a standardized norm, radiologists are needed to be aware of the terminology to describe the exams that are been performed. Knowing the correct verbiage helps in eliminating time and costs in appeals and even the necessity to provide additional information. A perfect example, a physician dictating a CTA should also include documentation of 3D imaging.
Review of templates and review titles, seamless communication with your billing company and staying up to date with CPT updates will be of prime significance. Changes in equipment, techniques as well as protocols need to be shared with your medical billing extension so that it can incorporate the same. The billing company should be acting as a safety check and can provide the much needed accuracy with timely updates.