Streamlined Radiology Billing for Stronger Financial Results

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Radiology Medical Billing Services | Acuity Health Solutions

Precision in radiology billing is required in the areas of global vs. split billing, technical/professional elements, complex modifier elements, and modality-specific payer requirements. Since MRI prior authorizations to nuclear medicine bundling, one coding error will cause a mass denial.

Acuity Health Solutions provides medical billing services in radiology in the United States and maximizes radiology Revenue Cycle Management of the hospital-based groups, freestanding imaging centers, and IR practices. We are a leading radiology billing company in USA where we attain 97% clean claims with specialized workflows.

Why Radiology Billing Requires Specialization

Dual Revenue Streams:

Technical Component (TC): Equipment, technologist, facility.
Professional Component (PC): Radiologist interpretation (-26 mod)

High‑Denial Modalities:

MRI/CT: Previous auth + medical necessity report.
Interventional Radiology: Complexity bundling (75998 fluoro guidance)
Nuclear Medicine: Tracer billing (A9500 series)
Mammography 3D tomosynthesis (G0279).

Payer Challenges:

Medicare PFS global billing rules
UnitedHealthcare site‑of‑service edits
Anthem LCDs for advanced imaging
Medicaid prior auth thresholds

Acuity's Radiology RCM Service Process

1. Modality‑Specific Charge Capture

RIS/PACS integration (Epic Radiant, Cerner RadNet)
Procedure logging by a technologist
Daily charge reconciliation
Global/split billing validation

2. Precision Radiology Coding

Certified radiology coders (RCC specialty credential):
- 70000-series diagnostic codes
- 36200-36228 angiography
- 76937 ultrasound guidance
- G0206 digital mammographic diagnostic

3. Claim Scrubbing (99% clean claims):

Modifier -26 TC/PC splits
LCD/NCD medical necessity
HCPCS Level II validation
Site‑of‑service compliance

Radiology Practice Types We Support

Hospital‑Based Radiology Groups

Radiology Medical Billing services in USA handle professional fees in various locations.

Freestanding Imaging Centers

Outpatient MRI/CT/US radiology revenue cycle management.

Interventional Radiology

Radiology RCM service, high complexity, vascular, biopsy, and drainage procedures.

Breast Imaging Centers

Optimization of the 3D mammography, MRI breast, and stereotactic biopsy.

Technology Integration for Radiology

RIS/PACS Seamless Connectivity:

Epic Radiant, Cerner RadNet
GE Centricity, Philips IntelliSpace
Custom HL7/FHIR interfaces

Real‑Time Radiology Dashboards:

Exam volume by modality
Denial rate by CPT code
A/R aging by payer
TC/PC revenue split

Proven Radiology Billing Results

Multi‑Hospital System → 92% clean claims
Imaging Center → A/R 45→28 days
IR Group → $1.8M revenue recovery

Key Metrics:

Denial reduction: 26%
Revenue uplift: 14%
A/R improvement: 35%

Radiology Prior Authorization & Medical Necessity

Acuity Health Solutions negotiates the prior auth requirements in complicated radiology medical billing services in the USA:

High‑Risk Modalities Requiring PA:

MRI/CT Lumbar Spine (back pain <6 weeks)
PET/CT Oncology staging
Cardiac CT angio (chest pain workups)
3T MRI (non‑standard indications)

LCD‑Driven Medical Necessity:

L38767: MRI cervical (failed conservative tx)

L35041: Wound debridement frequency limits

L38367: PET/CT specific cancer types

Our Authorization Success:

92% PA approval rate
eviCore/NaviNet integration
Fast tracks (48hr turnaround)
Documentation support in clinical trials.

Outcome

28% increased imaging approvals, removing delays in treatment in radiology practices across the country.

Interventional Radiology Billing Complexity

IR procedures demand specialty expertise within radiology RCM service:

High‑Complexity IR Coding:

36200-36228: Selective catheterization

75998: Fluoro guidance (bundling risk)

36556: PICC placement

61626: Stereotactic radiosurgery

Common IR Denials:

Global surgery bundling

Missing -59 modifier distinct service

Medical necessity documentation gaps

Acuity IR Solutions:

RCC‑IR certi
fied coders Pre-billing modifier validation
78% denial appeal success
TC/PC revenue optimization

Why Choose Acuity Health Solutions

Radiology‑Certified Specialists:

RCC, CPC‑IR credentials

10+ years imaging RCM

Weekly payer portal monitoring

Dedicated IR coding team

Schedule Your Radiology Billing Consultation

Advanced Radiology Revenue Cycle Management for Complex Imaging Services

We optimize every stage of your billing process to reduce revenue leakage, improve claim accuracy, and maximize financial performance across diagnostic and interventional radiology.

✔ Radiology-Certified Coders

✔ High-Cost Drug Billing Accuracy

✔ Faster Authorizations & Payments