Eligibility & Verification
Confirm insurance, benefit coverage, pre-authorization requirements to avoid rejected imaging claims.
Full revenue cycle management for X-ray, CT, MRI, ultrasound, nuclear medicine, and interventional radiology — coding, split billing, submission, and denial recovery for imaging centres.
Confirm insurance, benefit coverage, pre-authorization requirements to avoid rejected imaging claims.
Accurate CPT / HCPCS / ICD-10 coding for diagnostic imaging, interventional procedures, nuclear medicine, ultrasound, mammography and more.
Proper billing split for imaging equipment use (TC) and radiologist interpretation (PC), with correct modifiers.
Accurate charge capture, claim build, electronic submission and tracking across modalities and payers.
Post remittances, reconcile ERAs, manage patient balances, track collections and clean-up aged AR.
Analyze denial root causes — incorrect modifiers, missing components, payer edits — resubmit or appeal to recover revenue.
Detailed dashboards on modality mix, payer performance, claim turnaround, denial trends and revenue metrics.
Regular audits to ensure documentation, coding, modifier use and payer rules compliance.
Seamless integration with RIS/PACS/HIS systems, streamlined data flow from imaging to billing.
Confirm payer, benefits, prior-auth requirements before scheduling imaging.
Record imaging modality, number of views, study details, ordering physician, and clinical indication.
Assign correct CPT/HCPCS/ICD-10 codes, apply modifiers, split TC/PC components correctly.
Compile and submit claims electronically or via required payer format, including attachments as needed.
Process ERA/EOB, apply payments, adjust for co-pays or deductibles, post patient balances.
Review denials, correct documentation or coding errors, resubmit or appeal promptly.
Provide dashboards on modality utilization, denial rates, payer performance, and revenue metrics.
Ongoing audits to ensure documentation integrity, coding accuracy and payer compliance.