When we ask radiologists about their collections, they usually say, “We capture most of our revenue, but you know how radiology is, you can’t collect it all.”
Stop thinking this way and open yourself to maximizing your collections.
When we investigate the billing practices being used in radiology, they do not match the trends happening elsewhere in healthcare. These trends include: 1) rises in high-deductible and HSA plans; 2) more restrictions and pre-authorization for procedures; 3) increases in patient-due balances; and 4) uncertainty in the self-pay population.
Radiology billing and collection practices tend to follow the same workflow they have for more than 20 years. We wondered why so little has been done to make things better. Here is what we have found:
- Groups are comfortable in what they are being compensated
- Groups do not know how to make effective changes
- Groups are afraid of volatility in cash flow given the current economic environment.
These are great reasons for not acting, but you should be open to the benefits that increasing your collections brings. Among them it:
- Mitigates the continuous threat of changes in both government and insurance reimbursement rates, thus allowing you to pay your physicians a consistent annual compensation
- Makes you less vulnerable to decreases in reimbursement
- Avoids conflicts among practice, hospitals, and imaging centers due to inaccurate or bad data
- Helps minimize the subsidy a hospital may pay, thus strengthening the relationship between the radiology practice and the hospital
- Creates space for you to develop projects that protect and increase your compensation for the future
- Reduces conflict in your practice.
My next report will spell out steps you can take to improve collections. Here are five processes that we will cover:
- Patient access – front desk protocols
- Eligibility verification
- Early-out program
- Billing and collection audit
- Communication between hospital and radiology practices.
Mr. Jethani is CEO of Medical Imaging Specialists. He can be reached by e-mail at jethani@medicalimagingspecialists.com.
