What Makes Radiology Medical Billing Difficult?

How can we reduce difficulties in  Radiology Medical Billing?

Radiologists must be experts in diagnosing and monitoring various ailments, as well as predicting their outcome. They also need to play an important role in the management of IT applications for healthcare. As both private and public payers scrutinize imaging services, it can be difficult to get the right reimbursement. Most practitioners find radiology medical billing and coding cumbersome because it can be difficult to keep up with changes in payers and regulations. Billing and coding inconsistencies can be common in busy environments.

Compliance issues can always arise. There might also be lost charges and under-coded fees. Most errors can only be found when claims are disputed or audits are conducted. Medical billing and coding are crucial to your business’s survival.

The latest changes to radiology services include the following:

Coding Provisions and Revisions

National Correct Coding Initiative (NCCI), and The Centers for Medicare & Medicaid Services (CMS), have made some changes to coding policies and revised the codes. The NCCI has corrected radiotherapy planning codes, while CMS has modified coding practices for low dose CT lung cancer screenings.

Data Analytics: The New Boom

Experts in the field tend to highlight data analytics as the driving force behind the current medical facilities. Analytics based on workflow and big data help to drive more value, which allows the process to move more quickly and efficiently.

Value-Based payments

Due to falling reimbursements and increasing business expenses, a lot of radiologists are part of the physician quality reporting program. The incentives offered by PQRS tends to rise every year. To be eligible for a bonus, one must report on three measures per doctor.

According to the American College of Radiology, despite the fact that radiologists have been more successful in qualifying for PQRS incentives each year, 76.3% of radiologists still paid penalties of $2,654 in 2016.

Managing Swift in IT Systems

It is well-known that radiology practices are more likely to alter IT systems when they face data migration problems. To be able to create contingency plans and a realistic migration plan, they must work with the vendor of the IT system. It is essential to make sure that cleanups are done correctly.

Enhance Workflow Management

Orchestration in the imagining informatics space is driven by the consolidation of the healthcare sector, where many radiologists work in larger groups.

In order to avoid billing errors or irregularities, radiologists should be subject to increased surveillance. According to the Radiological Society of North America, imaging usage has increased dramatically over the past decade without an increase in reimbursement. This has led to a greater gap between productivity and reimbursement.


Outsourcing radiology billing services would allow them to resolve many of these issues and streamline the vital activities that they perform for radiology practitioners. Medcare MSO has a reputation for providing medical billing and revenue cycle management services. You can rest assured that the outsourcing of radiology billing services will ensure compliance with all payer rules and radiology coding. Radiologists will have the ability to use PQRS-specific reporting codes and correct codes to submit claims.

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