This article continues our series focusing on how to avoid radiology claims denials. In our first article, we covered Patient Eligibility Problems. Now let’s look at the topic of procedure authorization, specifically the failure to obtain proper authorization before the service is performed.
How to Avoid Radiology Claims Denials - Authorization on August 10, 2016
How to Avoid Radiology Claims Denials – Eligibility Problems on June 18, 2016
Claims for reimbursement of radiology services are most often denied by the payer, whether it is Medicare or a commercial insurance company, because they contain inaccurate information about the patient’s eligibility for coverage. This can occur for many reasons, some of which may not be within the control of the radiology practice, but it usually can be corrected by improving the process of recording data at the time of patient registration. In this new healthcare economy where radiology practices are under pressure to add value to the patient care delivery system, effective management of claims denials can strengthen the relationship between the practice or imaging center and the hospitals they serve.