Almost all of us in the medical imaging industry seem to find ourselves with decreased revenues.  If you are like me, then you’ve been wondering, “What can my imaging team do to improve our current revenue cycle?

The internet is full of examples and advice from experts on how imaging teams can improve their revenue cycles.  Their solutions all share a few key points such as, 1) Use your analytics to spot payment delays and claim rejections early, 2) leverage technology to ensure claim correctness quickly and 3) consider alternate revenue sources by providing services for other facilities.  Let’s see what we can learn from some specific examples…

Spotting Payment Delays and Claim Rejections Before They Happen

The key to identifying and preventing issues in your current revenue cycle is a having great analytics.  Take the time to look through your analytics reports for the following:

  • Types of medical records that tend to hold up claim submission
  • Performance stats on your staff to see how well they provide information that supports medical necessity
  • An analysis of claim processing by claim type and billing codes 
  • A list of rejected claims and the reason for their rejection

With these analyses in hand, you can determine which members of your staff need additional training, and which among your staff should handle certain claim types, and what processes need to be corrected.

Having trouble finding insights you need from your data?  medQ’s clinical analytics Dashboard makes spotting trends and capitalizing on opportunities like these a breeze.   

With recent events, it can be easy to fall behind on claim filing, however, it doesn’t take long for claims the pileup. If this is the case for you, or you are looking to speed up the claim filing process while improving your accuracy, consider the next tip… 

 

Use Technology to Create “Rejection-proof” Claims

Based on results of your data analysis, you might choose to invest in software that automates the claim verification process and partially fills in the claim prior to your submission.  This is usually done by the billing software or billing module.

Sometimes all it takes to hold up a claim is incorrect birthday or a mis-typed a zip code.  In addition to being able to automatically “scrub” your claims for accuracy, many billing modules should integrate with your RIS or EMR so that patient demographic, insurance and contact information are automatically carried forward to billing and claims.  For imaging teams, if your billing module is like medQ’s Integrated Billing, it should also be able to automatically capture the contrast dosage and other charges that apply as the procedure is performed.

Let’s also look to the near future.  As far as we know, the penalties for not complying with new AUC/CDS requirements will still go into effect January 2021.  If you don’t have an integrated CDS tool lined up for 2021, be sure to check out medQ’s solution.  It automatically flags studies that require CDSM consultation, and allows proper codes to be easily obtained in a physician’s portal or during order entry.

Consider Alternate Revenue Streams

A recent AuntMinnie.org article tells the story of Dr. Jason Weisner and his team at Sutter Health.  Back in the 2016, the team decided to invest heavily in remote reading resources.  This allowed his team of radiologists and to work from home at a variety of different times, including the night shift.  This, in turn, allowed his team to stop paying for outsourced night reads.

At the same time, you could begin to read for other sites.  This will necessitate some outreach on your part, and a minor technological investment to be sure that your system can accept images from the outside and keep their studies and patient information organized alongside your own.

Some solutions, like medQ’s Reading Services Module easily incorporate outside exams from an unlimited number of sites on a single Universal Worklist, enter outside orders automatically, create patient procedure histories, and distribute finished reports in the sending site’s preferred format.

Conclusion

If you are looking to improve your revenue cycle and speed up your recovery post-COVID-19, make sure you are considering alternate sources of revenue, using your analytics to identify revenue barriers, and leveraging modern billing technology to ease the exhaustive burden of repeated accuracy checking.