Medical Billing Watch – CMS Watching Radiologist Billing

A two year study by Medicare showed that Radiology providers billed Medicare inappropriately for a staggering 100,034 radiology services according to HHS Office of Inspector General (OIG). This translated into Medicare overpayments to the tune of $20 million dollars where Medicare Part A covered radiology services but providers still billed Part B for the technical component of those services as if they were outpatient services according to the OIG report. In a nutshell, Medicare paid these claims twice.

Prepayment edits are the proposed solution to this matter and would disallow the submission of any medical billing claim that had the same services under Part A and Part B claims. If you’re not sure your staff can keep up with this aspect of medical billing any longer, consider it may be time to outsource your medical billing claims to a third party partner that not only has the time to keep up with the changes but can help you manage your practice as well helping with your A/R, collections, getting the best reimbursements for your services rendered and helping your practice avoid audits and over payment situations with your medical billing claims.

This will free up your staff so you can do what you do best – expand your practice and service your patients without the headache of keeping up with your medical billing.

View all Articles by: Kathryn E, CCS-P - Retired