HAP Radiology Billing and Coding Blog

You should evaluate your practice’s revenue cycle management method at least annually, whether you have an outsourced RCM vendor or if your billing and collection is done in-house.

If you currently outsource your revenue cycle management, you know that the performance of your billing company is paramount to your practice’s financial success. Reimbursement continues to decline, and the migration to value-based payments from fee for service will continue to jeopardize your practice finances if your revenue cycle partner is not performing.

As private insurance payers begin adopting the Multiple Procedure Payment Reduction (MPPR) methodology that was implemented by Medicare several years ago, practices that are not ready could face a revenue loss of 25% or more for some services. Of specific interest to radiologists is United Healthcare, which announced in its May 2014 Network Bulletin that it would be expanding its MPPR to the professional component of imaging services in alignment with Medicare’s policy. This change will apply to United Healthcare’s Commercial and Community Plan. Originally the policy was to take effect in the third quarter of 2014 but under pressure from radiology advocacy organizations, United has now reported that implementation of the policy will be delayed until the fourth quarter of 2014. This brief reprieve provides radiology practices with an opportunity to lessen this detrimental impact on their revenue by improving their current processing methodologies before these changes take place.

HAP was recently named as the top medical coding company in this article by Medical Coding and Billing Online, a site dedicated to helping students explore education opportunities within the industry. In thanking them for this recognition, we also want to take the opportunity to recognize and thank our team of coding professionals for the excellence that they deliver to our clients on a daily basis.