Wiki Family Practice Radiology Billing

[Melissa924]

Hello,
We are a family practice, with a radiology tech on staff and we own our equipment. We have a contract with an outside entity to perform the radiology reads. We pay a flat rate per read, and the outside entity does not bill to insurance.
Should we be able to bill globally for this service?
I have seen contradicting information.
Currently, we are only billing the (TC) technical component, but I am curious what others are doing and if we could bill these globally to help offset the cost of the read.

Thank you all!!

 

[shanamarie]

Hello,
We are a family practice, with a radiology tech on staff and we own our equipment. We have a contract with an outside entity to perform the radiology reads. We pay a flat rate per read, and the outside entity does not bill to insurance.
Should we be able to bill globally for this service?
I have seen contradicting information.
Currently, we are only billing the (TC) technical component, but I am curious what others are doing and if we could bill these globally to help offset the cost of the read.

Thank you all!!

Does the provider doing the read, bill insurance for the service with a modifier 26? Or are you saying they don’t bill at all? If they aren’t billing for the read and you aren’t either then this is not being billed or reimbursed by insurance correctly, and is essentially a loss in revenue.

We have a company that performs our readings as well but we pay them for each read, and we bill the entire service without any modifiers.

 

[rthomas@impcna.com]

Hello,
We are a family practice, with a radiology tech on staff and we own our equipment. We have a contract with an outside entity to perform the radiology reads. We pay a flat rate per read, and the outside entity does not bill to insurance.
Should we be able to bill globally for this service?
I have seen contradicting information.
Currently, we are only billing the (TC) technical component, but I am curious what others are doing and if we could bill these globally to help offset the cost of the read.

Thank you all!!

Our practice also has a radiology tech, our own equipment, and contracts with an outside radiologist that we pay a flat rate per read. All of our providers do read their own x-rays, but if they are not 100% sure about something or want a second opinion that is when they will send it for over-read. We bill global as long as the practice provider has documented their findings and indicates that it has been sent for over-read for whatever reason.