Radiology Billing Services for Imaging Centers and Radiology Groups
Radiology is a volume game with very little room for error. Each study can be billed whole, or split into a technical part for the equipment and staff and a professional part for the read, and the right split depends on who did the scan and who interpreted it. Layer on payer authorizations, ordering provider requirements and medical necessity edits, and one missing detail can hold up dozens of studies at once. We bill for imaging centers and radiology groups with that volume in mind.
Why imaging claims get stuck
Six problems we see again and again in radiology.
Technical, professional or global
Studies are billed global, TC only or professional only (modifier 26), depending on whose machine it is and who reads the study. A wrong call means denials, duplicate billing or lost revenue.
Authorizations and benefit managers
Many payers require authorization for advanced imaging like MRI, CT and PET, often through a separate radiology benefit manager. A missing or mismatched approval is a common reason for denial.
The ordering provider
Claims need the ordering or referring provider with a valid NPI. If that is missing or wrong, a study that was done correctly can still reject or deny.
Medical necessity and diagnosis codes
Payer policies tie imaging to specific diagnoses. A diagnosis that does not support the study, or is not specific enough, gets denied.
Contrast, supplies and same-day studies
Contrast agents and supplies are billed under their own codes, and several studies on one day can trigger reductions and bundling edits under payer rules.
Screening or diagnostic?
Screening and diagnostic studies of the same type use different codes and are covered and cost-shared differently. A screening that turns diagnostic needs the right coding and documentation.
How we work with imaging providers
From the order to the posted payment.
Imaging benefits before the scan
Active coverage and imaging benefits get checked through eligibility verification before the patient is on the table.
Approvals matched to scheduled studies
Some payers ask for approval and some do not. We sort that out, file the request through prior authorization, and tie each approval to the study it covers.
Study and component coding
Study codes, TC and 26 components, modifiers and diagnosis links get a second look from our medical coding reviewers.
Charges tied to the reading log
Studies, contrast and supplies go through charge entry and are reconciled with the schedule and the reading log, so nothing falls through.
Large claim batches
Big batches pass payer edits before our claim submission team sends them, and rejections are worked as they come back.
Posting by study and component
Payments are posted by study and component, and reductions are checked against what we expected.
Authorization and ordering-provider denials
When a study is denied for authorization, medical necessity or ordering provider reasons, our A/R and denial team picks it up.
Radiologists and imaging sites
New radiologists and new imaging locations go through credentialing before they bill, and we track renewals.
Trends by study type
The monthly report breaks denials down by study type and referring source, next to A/R by payer.
Your RIS and billing systems
We work inside your RIS, the billing system tied to your PACS, and your practice management software. Nothing to replace.
Onboarding an imaging practice
How we go from kickoff to steady work.
Size up your volume and mix
We look at which modalities you run, how many studies you read, and who refers them.
Record the payer edits
Authorization rules, benefit managers and TC and 26 handling are documented for each payer.
Connect securely
We get secure access to your RIS and billing system, then agree on a short checklist for the scheduling desk.
Run the claims
From eligibility to follow-up, each step has a schedule we set with you at the start.
Review by modality
We go through denials and A/R with your team, sorted by modality and referring source.
Also worth reading
Authorizations for advanced imaging
Advanced studies often need an approval before anyone is scanned. See our prior authorization services.
Claim volume
See how we handle high-volume claim submission.
Cardiac imaging
Cardiac imaging follows similar rules. See our cardiology billing services.
Find out where imaging claims are stuck
Authorization denials, ordering provider rejections and TC and 26 mix-ups quietly eat revenue at imaging practices. If any of that sounds familiar, tell us a little about your setup. A free billing audit is where most groups begin.
Get a Free Billing AuditCall (321) 788-3655Frequently Asked Questions
What imaging groups ask before they hand over billing.
1. Do you bill technical and professional components separately?
Yes. We bill global, technical-only or professional-only services with the right modifiers, based on who performed and who interpreted each study.
2. Can you get authorizations for MRI, CT and PET?
Yes. We confirm what each payer wants, file the request, follow it to approval, and tie it to the study on the schedule.
3. What if the ordering provider is missing from the claim?
We flag it and work with your team and the referring office to fix it, since missing ordering data can reject or deny a claim.
4. Can you keep up with high study volume?
Yes. Every claim runs through edits first. Rejections get worked as they return, so a busy week does not turn into a backlog.
5. Do you work with both imaging centers and radiology groups?
Yes. We support independent radiology groups and imaging centers.
Related imaging and lab work
Neighbors of radiology in many practices.
Cardiology Billing
Echo, nuclear and stress testing, with their own TC and 26 questions.
Laboratory Billing
Panels, medical necessity and the edits that come with lab volume.
Multi-Specialty Billing
Imaging sitting beside other departments in one group.