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Why does radiology revenue cycle management involve more moving parts than most people assume? One imaging study may be eligible for multiple codes based on the type of imaging performed, the use of contrast, and the diagnosis rendered; payers often wonder about the medical necessity when the ordering diagnosis does not clearly support the imaging performed. Include prior authorization requirements if the study is MRI/body or CT, or other higher-cost studies, and claims may languish before they are even submitted. Radiology revenue cycle management needs to catch these gaps early, confirming authorization, matching diagnosis to modality, tracking claims through to payment so practices aren't left waiting on reimbursement for studies that were already completed and delivered.
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