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How much do Radiology Practices pay to manage the Average Denial?

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One of the most exasperating occurrences during medical billing for a practice and its billers is a denied claim, as it equals to efforts resulting in non- payment as well as resubmission of the claims.

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How much do Radiology Practices pay to manage the Average Denial?

  1. 1. End to End Medical Billing Solutionshttp://www.medicalbillersandcoders.comwww.medicalbillersandcoders.comCopyright ©-2013 M.D.C.P. All Rights Reserved.Page 1 of 3How much do Radiology Practices pay to manage the Average Denial?One of the most exasperating occurrences during medical billing for a practice and its billers is a deniedclaim, as it equals to efforts resulting in non- payment as well as resubmission of the claims.Unlike earlier when radiology groups did not pay much attention to their revenue cycle, with increasingpayer denials and regulations they are now forced to take every possible step to ensure efficient billing inorder to remain successful.Industry Standards StateIt costs $25 to $30 to manage the average denialFrom the total claims filed nearly 30% get denied, however any rate over 10% should beevaluated closelyMost radiology groups will be at a competitive disadvantage without a good system capable of minimizingdenials and resolving them quickly when they do occur.Most frequent types of denials-Type of Denials Average Percentage of DenialsMedical Necessity 18%Procedure Bundling 11%Duplicate Claims 14%No Prior 13%Authorization 10%Untimely Filing 10%The percentages do not add up to 100% as only the six most common denials have been listed above
  2. 2. End to End Medical Billing Solutionshttp://www.medicalbillersandcoders.comwww.medicalbillersandcoders.comCopyright ©-2013 M.D.C.P. All Rights Reserved.Page 2 of 3How to reduce or avoid denials?To procure higher reimbursements the best thing practices can do is to improve denial management andsubmit cleaner claims from the start. Besides Radiology Groups to improve their denial management processrequire to fully integrate it with their practice management, medical billing and so on.Most radiology groups already overloaded with work and very little time are left with the question whetherto take up denial management in house or to simply outsource.Denial management - in house or outsource?The entire denial management process is a daunting task especially as sifting through all the denials is acostly and time-consuming endeavor, requiring commitment, resources and cooperation across the group.Hence most radiology groups can benefit by outsourcing to a medical billing partner with proven capabilitiesof providing a complete list of denial management services.Reducing denials with MBC as your radiology billing partner!• Proactive and on-going process which reduces the probability of denials from thebeginning and also address them promptly when they do occur• Patient data management is carefully organized, we also provide consultancy to helpassists radiology groups integrate the information into their billing software system• Timely reports and accuracy checks are done regularly as correct medical histories andmedical necessity documentation are critical to accurate claim submissions• Monitoring of claims submitted and providing regular reports on the status of alloutstanding claims• Analysis of denial trends by mapping patient accounts and claims to specific plans andpayers along with making detailed notes, finding denial codes and denial appeal codes• Analysis of payer contracts which includes matching payments for specific procedureswith payer contracts and creating reports depicting multiple instances of incorrectpayments from a certain payer• Payer specific guidelines are constantly updated especially due to increasing numberof payer requirements which helps prevent unnecessary denials
  3. 3. End to End Medical Billing Solutionshttp://www.medicalbillersandcoders.comwww.medicalbillersandcoders.comCopyright ©-2013 M.D.C.P. All Rights Reserved.Page 3 of 3MBC is the largest consortium of billers and coders across all 50 US states serving varied specialties includingradiology for over a decade. Our biller and coders are well trained in the many nuances of radiology codingand also have the requisite certifications such as the Certified Procedural Coder (CPC), the RadiologyCertified Coder (RCC).Browse All: Radiology BillingMBC’s billing services can help reduce your denials with the help of the following tools -Charge entry analysis + Tracking payer denials + Tracking claim status andresubmissions + In depth analysisRadiology groups with maximized and accelerated cash flows!

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