MedCare MSO provides scalable radiology billing services to meet the unique needs of your practice. These comprehensive services include revenue cycle management (RCM), accounts receivable recovery, electronic health record/electronic medical record (EHR/EMR) technologies, Radiology Billing, and patient engagement services.
Partner with us for streamlined radiology billing services, so you can focus on patient care with ease.
As a leading radiology billing company, we will help you with:
MedCare oversees accurate billing for physician services across different radiology sectors, ensuring practices receive the payment they deserve and preventing billing interruptions.
We fulfill the requirements of hospital and SNF billing, ensuring claims are processed in accordance with payers' recent rules and industry standards.
MedCare has certified coders ensuring the right application of CPT, ICD-10, HCPCS codes, modifiers, (e.g., modifier-26, modifier-TC), and Dx codes for all types of radiological services to enhance the success rate of claims.
We provide support by billing advanced imaging such as X-rays, MRI, CT scans, other imaging services, other components like TC, PC, and global billing.
MedCare presents precise billing reports that provide full information on patient charges, payments made, amounts approved, and all details related to refunds.
MedCare investigates the EOBs to which it identifies payment problems, solves disputes, and launches appeals to recover the lost funds.
Our radiology billing service can recapture cash by addressing the problem behind every denial, thus preventing the same denial from happening again and maintaining a low overall denial rate.
We guarantee that no radiology claims fall behind in accounts receivable because every claim is automatically identified and traced in a standardized way.
Each denial includes the payer and the reason for denial, and is classified as medical necessity, prior approval, modifier failure, timely filing, or other reasons to apply the appropriate remedy.
The core of the subject is uncovered in case a denied claim means issues with coding, medical documentation, or eligibility.
If a claim is denied, it is appealed with all necessary clinical documents and coding.
The cash returned is properly credited to our client's account.
Partner with expert radiology billing services in USA to enhance coding accuracy, accelerate reimbursements, and strengthen financial performance.
Request a ConsultationOur radiology medical billing service providers review patient records and assign the appropriate diagnosis codes, including claims that contain only a rule-out diagnosis. That means quick, timely reimbursement for you.
Understanding the payer policies, especially Medicare’s NCCI edits and MPPR rules, is crucial for proper reimbursement. Not following these rules can result in claim rejections or reduced payments.
Before submitting claims, we take the time to thoroughly review them to ensure that all codes are accurate and in line with NCCI edits. Our radiology billing services software can identify potential issues, which helps to reduce errors and streamline the billing process. The results? Better, faster, & higher reimbursements.
Obtaining prior authorization for advanced imaging procedures like MRI, CT, and PET scans is time-consuming and can delay patient care. Denials for lack of pre-authorization result in revenue loss and an increased administrative burden. We take a proactive approach by:
Not all denials come from the same root cause, so we don't treat them the same way. Our denial management approach categorizes and resolves each type at the source:
Insufficient clinical justification for advanced imaging. We work with radiologists to strengthen documentation (history, indications, diagnostic codes) before submission, and prepare detailed appeals with clinical support when denials do occur.
Missing or expired authorization for MRI, CT, and PET scans. We build proactive authorization workflows and follow up with payers before the procedure date, not after a denial.
Incorrect TC/PC/global splits or missing modifiers (26, TC, 59). Caught pre-submission through coder review and automated scrubbing.
Procedures billed together that payers consider inclusive. Reviewed against current NCCI edit tables before claims go out.
Caught at verification, before the claim is ever filed.
Our targeted denial management solutions help resolve coding, authorization, and payer-related issues faster.
Add a single AI product that fixes your biggest bottleneck, or integrate our complete AI Ecosystem into your radiology revenue cycle. Either way, each one plugs directly into your billing workflow.
Syncs radiology clinical records including PACS/RIS data with billing and coding in real time.
Captures clinical documentation from patient encounters as structured data that feeds directly into coding and billing.
Assigns radiology CPT, ICD-10, and HCPCS codes with the correct modifiers, reducing manual coding time and pre-submission errors.
Handles scheduling, charge entry, claim submission, status tracking, billing for radiology, and imaging centers.
Connects your existing systems securely to enable smooth, real-time data exchange and improved workflow efficiency across platforms.
Automates repetitive administrative, billing, and data entry tasks to minimize manual errors, increase productivity, and save valuable time.
Uses advanced payer guidelines, claim validation rules, and coding logic to identify potential errors before claims are submitted.
Integrates artificial intelligence to streamline coding, prevent denials, analyze data, and enable smarter, faster revenue cycle decisions.
We provide accurate radiology billing and coding services for all imaging modalities, including X-ray, MRI, CT, ultrasound, and fluoroscopy, in compliance with TC, PC, and global billing regulations and laws, depending on the payer and facility.
We ensure that our vascular and non-vascular interventions, including angiographies, embolizations, stent implantation, biopsies, fluid draws, and S&I coding, are billed correctly.
We verify that all SPECT and PET studies are billed properly according to their components.
We ensure that brain and spinal MRIs, CCT, angiographic studies, joint imaging, and bone density studies are billed correctly for the specified subspecialty.
We track mammograms and related studies and capture and bill correctly, using the right code for screening versus diagnostic studies to avoid denials caused by a code error.
We are billing remote interpretation in line with payer’s rules.
Unlike other radiology billing companies, we prioritize transparency and personalized service.
High denial rates, administrative inefficiencies, and delayed revenue recovery due to complex billing workflow challenges.
to 8–13%, improved first-pass resolution to 91.3%, lowered A/R balances by 30%, and cut overhead costs by 50% through optimized billing operations.
| Metric | Before | After | Improvement |
|---|---|---|---|
| Denial Rate | 25-30% | 8-13% | Significant Drop |
| Clean Claim Rate | 50% | 91.3% | +30% Increase |
| AR Balances | High | Reduced by 30% | Revenue Growth |
| Overhead Costs | High | Reduced by 50% | Cost Savings |
MedCare MSO bills accurately across all radiology cost components, including the technical component (TC), professional component (PC), and global billing. Our radiology billing and coding services ensure accurate application of CPT, ICD-10, and HCPCS codes with modifiers like modifier-26 and modifier-TC, so every claim reflects exactly what was provided and is reimbursed correctly.
MedCare MSO delivers radiology medical billing services for therapeutic, interventional, and non-interventional radiology, including technical billing for advanced imaging like X-rays, MRIs, CT scans, and ultrasounds. We also handle professional services for physicians and claims for hospital and skilled nursing facility (SNF) patients, all coded to the latest standards.
Following Medicare’s NCCI edits and MPPR rules is essential to avoid rejections and reduced payments. Before submission, MedCare MSO’s radiology billing and coding experts thoroughly review every claim for code accuracy and NCCI compliance, and our radiology billing software flags potential issues, delivering better, faster, and higher reimbursements.
Yes. MedCare MSO is a Qualified Clinical Data Registry (QCDR) for MIPS reporting, helping your radiology practice meet quality requirements with accurate data. Our medical billing services for radiology are combined with compliance support for the No Surprises Act, ACR, CMS, HIPAA, OIG, ACA, and AMA guidelines to keep your practice audit-ready.
Yes. MedCare MSO’s radiology billing services in USA integrate with your existing radiology EHR/EMR and practice management systems, with PACS integration, patient scheduling, automated billing, and a built-in Radiology Information System (RIS). We also offer our own AI Scribe, AI Coder, and radiology billing software if you’d like to upgrade.
Prior authorization for MRI, CT, and PET scans is time-consuming and a common cause of denial. MedCare MSO helps practices outsource radiology billing services with a proactive approach, building efficient workflows for authorization requests and monitoring and following up with payers to speed approvals, so patient care isn’t delayed and revenue isn’t lost.
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