A Case Study On Radiology Billing

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A Case Study On
Radiology Billing
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A Case Study On Radiology Billing
Billing for radiology correctly requires more
than just keeping track of money. It is a
multi-phase process that necessitates
persistently calculating money on each step.
Throughout the expanding process, one needs to be
tenacious and proactive to ensure collection of
every cent which is due. Unique
ChallengesManagement and Personnel Radiologists
at a medical setting in Ohio called Medisys Data
Solutions into practice because they thought
something wasnt right. They employed a seasoned
practice manager who had been with them when
their firm commenced a new journey. The practice
manager showed very less enthusiasm in taking on
any billing responsibilities which kept piling up
on the desks. After a while, the group had
expanded to include more than 10 radiologists,
all of whom expected the practice manager would
handle the billing procedures. They lacked the
necessary team of motivated employees who were
trained in billing procedures, not to mention
they lacked certain coding experts and
qualifications for the same. The practice
manager was operating a one-man internal billing
department, which made things more difficult in
this situation. At Medisys Data Solutions, we
immediately noticed that all three of the
aforementioned scenarios which were taking place.
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A Case Study On Radiology Billing

• Analysis and audit
• Following these significant management and staff
  inefficiencies, our team at Medisys Data
  solutions highlighted several loopholes which
  plagued the whole billing system, leading to the
  majority of the data being erroneous and
  untrustworthy. Data entry was negligently
  handled, and there were a haphazardly increasing
  number of write-offs. We found that in order to
  hide the significant amounts of money being lost,
  their billing software was configured to
  calculate write-offs as contractual adjustments.
  Other errors and inefficiencies were as follows
• Payment postings were not balanced
• Posting partial entries
• Stacks of paper checks from previous months were
  piling up on the desks
• Around 6 months worth of pending charges
• All payments were made on paper with zero track
  of computerized transactions
• The billing team did not follow up with the
  address denials
• Lack of document filing and scanning techniques
  resulted in no record collections
• Days in AR were nearly 100 days
• Refunds made in error with sums in excess of
  mid-six figures

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A Case Study On Radiology Billing
Recommendations and Solutions Our initial
suggestion was to start outsourcing billing
operations right away because of the practices
serious personnel and management issues. The fact
that the practice was still unaware of the scope
and gravity of their billing issues contributed
to the resistance to this notion. As a result, we
got qualified managers who were familiar with the
current billing system. The most important
advice we gave was to start up a fresh instance
of the billing application. Once more, this
suggestion was rejected, therefore we were given
the duty of overhauling the entire billing system
without permission in order to start over with a
new billing software or an outsourced billing
system. Most billing companies would throw up
their hands in the air and think their options
were limited if the main recommendations were
rejected. The Medisys Data Solutions team worked
numerous hours and through the night over the
course of the following six months to restore
some normalcy to our clients invoicing system at
Ohio. Results Within the first six months, we
were able to modify their billing systems
settings such that they complied with RBMA
criteria for accounting and classification. This
indicated that the new data was entirely reliable
and accurate, which represented a sea change for
the industry. What came next was a series of
modest but effective measures to do away with
inefficiencies. Lets glance through them, shall
we?
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A Case Study On Radiology Billing

• Scanning and properly archiving all supporting
  files
• Payment reconciliation before posting
• Processing reimbursements after evaluating them
• Updating hospital admissions made while the
  billing system was in chaos, along with charges
  and payments
• Using trained coders for coding tasks and
  implementing PQRS
• Medisys Data Solutions served as a consultant
  on-site for around a year and a half. The group
  did, however, have one key component that you
  would anticipate from a practice, which is record
  keeping. As the old AR was whittled down, the Net
  Collection Percentage for all tax IDs averaged
  well over 100. The entire refund process was
  redesigned, which resulted in a halving of credit
  balances.
• Wrapping up
• It is time to know the income cycle of your
  radiology practice like never before. You can
  choose the level of support your office needs
  from our range of medical billing services for
  radiology practices, whether you need assistance
  regularly, occasionally, or occasionally. We are
  familiar with your industry and are aware of the
  steps necessary to restore your revenue health
  and provide you peace of mind.

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A Case Study On Radiology Billing

• Our offerings at Medisys Data Solutions looks
  like this
• Accounting and Receivables Management
• Compliance and Coding
• Management of Underpayments, Denials, and Appeals
• Contract Administration
• Collections of Self-Pay and Follow-Up on
  Insurance
• Analytics and Reporting
• Services for Practice Management
• To enhance processes, boost administrative,
  financial efficiencies, and enhance clinical
  decisions, Medisys Data Solutions offers
  market-leading analytics, extensive data, and
  unmatched connection and data transfer across
  providers, payers, and consumers. Utilize the
  power of the Medisys Data Solutions to hasten the
  change of healthcare. What are you waiting for?
  Were merely one tap away!

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