Why Radiology Billing Companies Require a Different Level of Expertise Than General Billing

At first glance, Radiology billing looks remarkably simple: a scan is done, a code is assigned, and a claim goes out. Actually, no other specialty is as complicated to code, scrutinized by payers, or has as much reimbursement risk as radiology. A generic billing staff team for primary care or basic outpatient claims may find themselves in trouble with the multiple layers of rules that govern imaging services. That is why many practices are often plagued by higher denial rates, delayed reimbursements, and lost revenue due to mismatched claims. What Makes Radiology Billing So Different? Radiology Billing is more than just using a CPT code for a scan. It is a multi-layer process that is not usually explained in general billing knowledge. Component splitting for professional and technical. The billing for many radiology services needs to be broken down into the professional component (interpretation) and technical component (equipment and staff), as appropriate, based on who rendered the p...