Historically, the federal government has taken the lead in pursuing fraud claims against healthcare providers. Section 6031 of the recently enacted Deficit Reduction Act of 2005 (DRA), which provides a financial incentive for states to enact their own false claims legislation, is changing that.
More »Considerable confusion remains in the radiology community surrounding what constitutes a valid order for a diagnostic test and who must generate that order. The confusion stems from the fact that there are two sets of rules.
More »'Tis the season for congressional wrangling over Medicare reimbursement to physicians. Before the 109th Congress adjourned, it did not eliminate reimbursement reductions to the technical side of imaging, which come from two reimbursement reductions included in the Deficient Reduction Act of 2005....
More »Over the last five years, outsourcing has become a global trend in business because, when performed properly, it can produce efficiencies not attainable when these functions are performed internally by an organization. Although outsourcing has existed in radiology practice for some time, its use has...
More »Radiologists frequently ask how they can maximize practice revenue. One way is to include proper billing documentation in dictated reports. This strategy will ensure the practice receives proper payment for services and that the proper documentation exists in case Medicare ever conducts an audit.
More »Common billing strategy relegates radiology group's well-being to second place
More »Radiology practices frequently use outside auditors to evaluate their billing service. These audits provide a valuable service to a practice. But physicians often have a misconception of the actual scope of an audit and the meaning of its outcome.
More »Most of the poor revenue performance confronting radiologists and radiology business professionals originates from weaknesses in the overall base design of the billing system. So, although much has been written on the micro aspects of radiology billing and reimbursement, this article takes a macro...
More »Radiology groups are producing more work per full-time equivalent than ever before. Yet in many cases, their incomes are flat or decreasing. One of the major factors contributing to this phenomenon is consolidation within the healthcare insurance industry. This consolidation has fueled new rounds of...
More »Convincing evidence suggests that, as suspected, managed care companies lack the ability to properly adjudicate claims and pay the contracted amount for services rendered.
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