SOLUTIONS FOR UNIQUE RADIOLOGY CHALLENGES
Navigating the complexities of radiology revenue cycle management
Radiology practices face certain challenges that complicate their revenue cycle:
Complex coding and billing
Each sub-specialty has its own intricate coding requirements that must be applied precisely to avoid denials and maximize reimbursements.
Prior authorization delays
High volumes of imaging services require fast, accurate pre-authorizations, which can be time-consuming and error-prone if done manually.
Claim denials
Frequent denials due to coding errors, eligibility issues, or inadequate documentation disrupt revenue flow.
Increased patient responsibility
As patients face higher deductibles, managing patient collections efficiently has become essential.
Compliance with regulatory changes
Keeping up with evolving healthcare regulations is crucial for avoiding penalties and ensuring consistent reimbursement.
ADVANCED CODING & BILLING
Accurate coding for radiology’s complex procedures
Radiology involves specialized coding for complex imaging procedures like MRIs, CT scans, and ultrasounds. Infinx’s AI-powered coding solutions ensure precise coding across sub-specialties, preventing costly errors.
Subspecialty specific coding
Automates coding for complex procedures like neuroradiology MRIs, musculoskeletal CT scans, and interventional radiology.
Improved claim accuracy
Reduces coding errors that frequently lead to denials in imaging services like mammograms or angiographies.
Real-time updates
Ensures coding is compliant with the latest CPT/ICD changes specific to radiology.
PRIOR AUTHORIZATION
Faster approvals for high-volume radiology procedures
Radiology practices often face delays in pre-authorization for high-tech imaging like MRIs and CT scans. Infinx automates this process, enabling faster approvals and reducing disruptions in patient care.
AI-powered automation
Speeds up prior authorizations for complex imaging, avoiding delays in urgent procedures like oncologic imaging or cardiothoracic scans.
Reduced cancellations
Faster approvals prevent the need to reschedule or cancel high-cost procedures due to slow authorizations.
Increased capacity
With quicker turnaround, your practice can handle more patients, optimizing the use of expensive imaging equipment.
DENIAL MANAGEMENT & PREVENTATION
Minimize denials for radiology-specific coding and claims
Radiology practices often face high denial rates due to coding errors in complex procedures like interventional radiology or neuroradiology. Infinx’s denial management platform helps identify and resolve these issues.
Subspecialty insights
Tracks common denial causes in high-risk procedures such as breast imaging or pediatric radiology, offering solutions to prevent recurring denials.
Automated denial resolution
Streamlines appeals for denied imaging services like CT and MRI, recovering lost revenue quickly.
Proactive prevention
Real-time data identifies denial trends, enabling adjustments in coding practices for procedures with high denial rates.
PATIENT ACCESS & FINANCIAL COMMUNICATIONS
Improve patient transparency for radiology costs
Radiology services, especially for advanced imaging like MRIs and PET scans, often involve high out-of-pocket costs. Infinx’s patient access solutions provide clear cost estimates, improving patient satisfaction and collections.
Upfront estimates for imaging procedures
Offer patients clear financial responsibility for expensive procedures like mammograms or CT scans.
Flexible payment plans
Provide options that help patients manage the costs of high-ticket procedures, reducing bad debt.
Enhanced patient satisfaction
By clearly communicating costs, you reduce confusion and delays in payment for advanced diagnostic imaging.
COMPLIANCE SOLUTIONS
Stay compliant with evolving radiology regulations
Radiology practices face strict regulatory standards, from HIPAA to CDSM mandates for advanced imaging procedures. Infinx ensures your practice remains compliant, reducing the risk of penalties.
CDSM compliance for imaging
Ensure adherence to decision support mandates for procedures like CTs and MRIs, which require documentation of clinical necessity.
Regulatory updates for radiology
Stay ahead of changes in regulations, particularly for imaging-specific standards around radiation safety and patient data protection.
CREDIT BALANCE & PAYMENT POSTING
Efficient resolution for radiology’s high volume transactions
Radiology practices, particularly large imaging centers, often experience credit balance challenges due to high patient volumes and frequent overpayments. Infinx automates credit balance resolution and payment posting.
Streamlined payment posting
Automates posting for high-volume imaging services like X-rays, MRIs, and ultrasounds, reducing errors in billing.
Credit balance resolution
Efficiently resolves outstanding balances, ensuring financial accuracy in radiology transactions.
Faster cash flow
By addressing unposted payments for costly procedures like angiography or interventional radiology, practices can recover revenue faster and reduce financial gaps.
Maximizing radiology outcomes
Financial outcomes
Radiology practices using Infinx’s RCM solutions experience a 10–15% increase in revenue due to more accurate coding and reduced denial rates. With 30% faster prior authorization approvals, providers reduce delays, improving cash flow. Additionally, a marked reduction in denials ensures a more consistent revenue stream, minimizing financial disruption.
Operational outcomes
Automation leads to a 70–90% reduction in manual tasks, freeing staff to focus on higher-value work, such as patient care. This increase in operational efficiency also results in improved patient satisfaction, as faster pre-authorization processing and clear financial communications lead to a better overall patient experience.
Clinical outcomes
Infinx’s solutions facilitate faster care delivery by reducing pre-authorization delays, enabling radiology practices to provide critical imaging services sooner. Additionally, streamlined workflows through automation reduce the administrative burden on clinical staff, allowing for more efficient operations and enhanced patient outcomes.
EDUCATION
Helpful resources for your team
We create educational materials frequently in the form of virtual office hours, articles, white papers, webinars and podcast episodes which help our clients and peers with common revenue cycle administrative burdens and challenges they face. If you would like us to address a specific topic, feel free to reach out to us.