Revenue Cycle Management

A successful radiology entity needs effective revenue cycle management to ensure there is adequate cash flow to fund the entity’s payroll and operations.  The radiology business professional needs to have a thorough understanding of the billing processes whether the billing is an in-house operation or outsourced.  A consistent cash flow pattern enables the entity to successfully achieve its business objectives. 

• Monitoring of RCM operations against internal and external KPIs
• Monitoring outsourced billing services
• Evaluate the use of AI in RCM operations and the associated implementation of the AI tools
• Payer agreement negotiations and ongoing payer relations/ monitoring of correct payments
• Coding
• MIPS and value-based reporting
• Payer credentialing/ enrollment
• RCM processes: Coding, Front end edits, payment posting, denials management (i.e., prior authorization, medical necessity), AR follow-up and appeals, statements, credit balance management, refunds
• No Surprises Act – staying up to date on NSA/ monitoring impact/ appeals