The revenue cycle is especially challenging to handle in radiology. Expensive equipment, complex payors’ regulations, and ongoing pre-authorization issues may result in payment delays and extended accounts receivable (AR) days. In radiology practices and imaging centers, effective accounts receivable management is essential to maintain healthy cash flow and facilitate technology acquisition financing.
AR days can only be reduced by an efficient, data-based system in which every process of the billing and follow-up process operates in cooperation. This blog details some of the best practices that will ensure that AR is not a bottleneck.
Improve Front-End Verification
Any AR problem begins at the front desk. Accurate collection and verification of insurance is the solution to good AR management. Pre-verification of patient demographics, insurance, and authorizations prevents downstream claim denials. Front-end staff should:
- Verify eligibility and benefits for each visit.
- Confirm pre-authorizations for imaging tests such as MRIs and CT scans.
- Notify patients upfront of their share.
This simple yet powerful step can prevent much denial that causes AR ageing
Submit Clean Claims
Clean claim submission is one of the fastest ways to eliminate AR days. Radiology billing involves many CPT and modifier codes, so accuracy matters. One error will suspend payment for weeks. To minimize rejections:
- Utilize computer claim scrubbing software that flags mistakes before submission.
- Conduct frequent coding audits.
- Standardize radiologist templates to harvest all payor-mandated data.
High and uniform first-pass acceptance rates are the secret to effective accounts receivable management.
AR Follow-Up Must be a Priority
Uncollected claims are among the largest contributors to artificially ballooned AR days. In-house, systematic AR follow-up is required to monitor all lingering claims. Radiology billing staff must:
- Sort the AR by payor and claim age.
- Follow up the high-probability, high-value claims first.
- Remind automatically and prioritize tasks with AR tracking software.
Track Denials and Find Root Causes
Denial patterns signal systemic weakness within your payment process. Tracking denial causes, like “lack of medical necessity” or “duplicate service”, will determine where flaws begin. After recurring problems are identified, teams can repair processes and prevent related denials in the future.
For instance, where there’s a high rate of rejection of claims due to the absence of authorizations, radiology personnel can employ an auto-pre-check mechanism to mark authorization requirements before scheduling. This pre-initiative, in the long term, significantly reduces AR ageing.
Regular Payor Communication
Payor relations are as essential as accurate billing. Regular communication ensures proper understanding of altering policies and settles disputes in a timely way. AR staff have to keep current payor contact lists, document all call notes, and settle outstanding claims effectively.
Building professional relationships with payors’ representatives also accelerates collections and appeals. The majority of practices realize that committed AR management partners are professionals at it, with vast exposure to the payor systems and escalation procedures.
Utilize Analytics to Inform Decisions
Transparency of information makes AR management proactive rather than reactive. Continuous reporting on AR days averages, denial percentages, and payor turnaround is priceless.
Dashboards can be used by radiology administrators to identify bottlenecks and then allocate resources accordingly. Predictive analytics software is also able to forecast dates of payment and aid in planning cash flow.
Consider Outsourcing AR Management
Some radiology practices and imaging centers have found it beneficial to outsource accounts receivable management services to a professional medical billing partner. We offer:
- Organized denial recovery and AR follow-up teams.
- 24/7 claim tracking and escalation.
- Analytics and advanced reporting tools access
- Improved first-pass rates and fewer days in AR
Outsourcing can decrease overhead costs while having continuing follow-up on claims and efficient operation, freeing in-house staff to be used for patient care and development.
Front-end activities should align to keep AR days as low as possible for both imaging centers and radiology practices. Solid processes are essential for financial security, whether conducted in-house or by outsourced AR management firms.
