In the eyes of Recovery Audit Contractors (RACs), there is a fine line between high-volume radiology billing and a compliance red flag. At the very center of that target? Bilateral & Multi-View Unbundling Traps. It’s an incredibly easy mistake to make. A busy billing team accidentally splits a multi-view chest X-ray or a bilateral extremity […]
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If your imaging center or radiology practice feels like it’s being run by RadMD (Evolent) or NIA (National Imaging Associates) rather than your own clinical team, you are not alone. Payer-driven Radiology Benefit Managers (RBMs) are designed to do one thing: act as gatekeepers to reduce utilization. But in reality, they often create an administrative
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In the world of Ambulatory Surgery Center (ASC) billing, the smallest administrative detail can mean the difference between a clean payment and a standard “claim rejected” notification. For many commercial and state-level payers, that detail is the SG modifier. The SG modifier (Ambulatory Surgical Center Facility Service) is the universal signal to the payer that
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Out-of-network (OON) billing is often viewed as a “necessary evil” in healthcare—a way to maintain fair market rates that often ends in a PR nightmare of patient disputes and “surprise” bills. But it doesn’t have to be a choice between your revenue and your reputation. At Healthcare Logic, we believe that transparency is the ultimate
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When a surgeon performs multiple procedures in a single session, payers automatically slash the reimbursement for secondary and tertiary lines—often by 50% or more. While these reductions are part of the game, many ASCs lose additional revenue because their billers don’t know how to fight for the maximum allowable. If your team isn’t expertly navigating
While the industry focuses on AI for clinical diagnostics, a massive shift is happening in the back office. If you are still relying on manual entry and “guess-and-check” billing, your practice is falling behind the technological curve. At Healthcare Logic, we believe AI shouldn’t just help you read scans—it should help you get paid for
The future of radiology isn’t just in the pixel—it’s in the process. Read More »
Your radiology practice is growing, and that’s a win. You’ve invested in state-of-the-art equipment and recruited top-tier talent to meet patient demand. But there is a silent revenue killer that often follows expansion: Credentialing Lag. 🛑 Nothing drains a practice’s momentum faster than having a world-class radiologist ready to read, only to realize they aren’t
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Is your ASC’s revenue cycle moving as fast as CMS? The Covered Procedures List (CPL) Shift The Ambulatory Covered Procedures List (CPL) is a moving target. With CMS constantly adding (and sometimes removing) complex cardiac, spine, and orthopedic procedures, keeping your coding team aligned with the latest approved list is a full-time job. If your
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Ambulatory Surgery Centers (ASCs) navigate a complex financial landscape characterized by the Hybrid Billing Trap (Facility vs. Professional). In this environment, the efficient management of both the Facility Fee and the Professional Charge is crucial, as the margin for error is exceedingly narrow. The intricacies of ASC revenue cycle management necessitate a meticulous approach to
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Struggling With Medical Debt? Solutions and Resources to Get You Back on Track Introduction: Medical debt is a significant burden for many Americans. According to a recent report by the Kaiser Family Foundation, nearly 137 million people in the U.S. have medical debt, and 43 million owe at least $2,500. [1] If you’re one of
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