Radiology Medical Billing That Captures Every Study You Read
ClainetRCM delivers end-to-end revenue cycle management built for radiology groups, freestanding imaging centers, and interventional radiologists. Stop losing revenue to split-billing errors and missing prior authorizations.
Certified coders verify the professional and technical split on every study and confirm the ordering diagnosis supports the exam before the claim goes out
Why Radiology Billing Demands a Specialist
Radiology billing lives or dies on details that generic billers miss. The professional and technical component split, radiology benefit manager prior authorizations, and strict payer coverage policies on advanced imaging all have to be right before submission, not after a denial.
Professional and Technical Split Billing
Modifier 26 and TC have to match who owns the equipment and who read the study. Global billing when the facility owns the scanner is one of the fastest ways to trigger a takeback on audit.
Radiology Benefit Manager Prior Authorizations
Most commercial payers route advanced imaging through a benefit manager. CT, MRI, PET, and nuclear studies are denied outright without an approval number on file before the scan.
Medical Necessity and Coverage Policies
Payer coverage policies define which diagnosis codes justify each study. We link the ordering physician diagnosis to the exam so the claim clears the policy edit on first pass.
Contrast, Multi-Region, and Bundling Rules
With and without contrast, multi-region studies, and same-session exams each carry bundling rules. Correct sequencing and modifier use protects the full allowable on every line.
Complete Radiology RCM Solutions
From charge capture to final payment posting, ClainetRCM manages every step of your radiology revenue cycle so you can focus on patient outcomes.
Radiology Medical Billing
Complete billing management built specifically for radiologists, imaging centers, and hospital radiology departments.
- Charge entry and claim scrubbing
- Electronic and paper claim submission
- ERA/EOB posting and reconciliation
- Denial management and appeals
- Patient statement and balance collections
Radiology Medical Coding
Certified coders with deep radiology coding expertise capture every procedure at the correct, compliant level.
- ICD-10-CM and CPT coding for diagnostic imaging
- Modifier 26 and TC professional and technical splits
- Contrast, multi-region, and combined study coding
- Interventional radiology and image-guided procedure coding
- Coding audits and payer policy compliance reviews
Healthcare Credentialing
Fast payer enrollment and re-credentialing so you never miss a payment because of a lapsed credential.
- Insurance enrollment and re-credentialing
- CAQH profile management
- Medicare and Medicaid enrollment
- Payer contracting and fee schedule review
- Ongoing status tracking and follow-up
Virtual Medical Assistant
Dedicated remote assistants to absorb your front-desk workload so your staff stays focused on patients.
- Prior authorizations and referrals
- Appointment scheduling and reminders
- Insurance eligibility verification
- Patient follow-up calls
- EHR data entry and documentation support
Accounts Receivable Management
Dedicated AR follow-up to recover outstanding claims and pull down aging balances across every payer.
- Aging AR review and prioritization
- Payer follow-up and escalation
- Patient balance collections
- Write-off and adjustment analysis
- Monthly AR performance reporting
Revenue Cycle Audit
A thorough audit of your radiology billing to surface revenue leakage and compliance risk before it escalates.
- Billing workflow assessment
- Coding accuracy and payer policy audit
- Denial pattern analysis
- Payer contract review
- Custom revenue improvement roadmap
Radiology Billing Challenges We Solve Every Day
Radiology groups face billing obstacles that generic billing companies consistently get wrong. We know them all, and we fix them.
Missing Prior Authorization
Advanced imaging denied because no benefit manager approval was obtained before the scan. Our team verifies authorization is on file before the patient is on the table.
Incorrect 26 and TC Splits
Billing globally when the facility owns the equipment, or splitting when it does not, causes denials and refund demands. We map every site of service to the correct component.
Medical Necessity Denials
The ordering diagnosis does not support the study under payer policy. We review the order against coverage criteria and query the referring provider before submission.
Duplicate and Overlapping Claims
Same-day studies from multiple orders trigger duplicate edits. We reconcile the worklist against submitted claims so legitimate repeat exams are paid, not rejected.
Missing or Unsigned Orders
Payers and auditors require a signed order with a clear clinical indication. We flag missing documentation before billing rather than after a records request.
Slow Reimbursements
Long AR days strangle cash flow in a high-volume specialty. We submit clean claims within 48 hours and escalate with payers until every study is paid.
Underbilled Interventional Procedures
Image-guided procedures are routinely coded below the work performed. Our audits regularly find documentation supporting higher-value, fully compliant codes.
Facility and Professional Coordination
Hospital-based radiologists lose revenue when facility and professional billing are not reconciled. We track both sides so nothing falls between them.
Get Started in 5 Simple Steps
Onboarding with ClainetRCM is fast and seamless. Most radiology practices go live within one week with no disruption to daily operations.
Free Consultation
We analyze your current billing setup and identify radiology revenue gaps at zero cost.
Custom Onboarding
We integrate with your EHR and PM system and configure radiology billing workflows.
Team Assignment
A dedicated billing team with real radiology experience is assigned immediately.
Claims Submission
Clean, policy-compliant claims submitted within 48 hours with real-time tracking.
Revenue Growth
Watch collections climb with transparent monthly performance reporting.
What We Commit To on Every Radiology Claim
These are the standards we control and hold ourselves to, written into every engagement.
From charge capture to claim submission, on every working day
Business days to onboard your radiology practice end to end
Between full accounts receivable reviews, every single cycle
Starting rate on monthly collections. No setup fee, no contract
Radiology Billing for Every Practice Size
Whether you are a solo teleradiologist or a multi-site imaging network, ClainetRCM delivers billing that scales with your read volume.
Independent and Teleradiologists
Solo radiologists and teleradiology readers who need accurate professional component billing without hiring in-house staff.
Imaging Centers and Radiology Groups
Freestanding imaging centers and multi-provider radiology groups looking to cut denial rates and shorten AR across every modality.
Hospitals and Health Systems
Hospital radiology departments needing enterprise reporting, compliance oversight, and clean reconciliation between facility and professional billing.
Frequently Asked Questions
We map every site of service to the correct component before the first claim. If you read studies on equipment you do not own, we bill the professional component with modifier 26. If you own the equipment and the interpretation, we bill globally. Getting this wrong is one of the most common causes of radiology refund demands, so we verify it during onboarding and re-verify whenever you add a location.
Yes. Our virtual assistants handle radiology benefit manager submissions from request through approval, including peer-to-peer scheduling when a request is initially declined. We confirm an approval number is on file before the study is performed, which prevents the single largest category of advanced imaging denials.
Yes. Our certified coders handle image-guided biopsies, drainage procedures, vascular access, embolization, and vertebral augmentation, including the catheter placement and supervision components that are frequently underbilled. We code from the operative report rather than from a charge sheet.
We check the ordering diagnosis against the payer coverage policy for that exam before submission. When the indication on the order does not support the study, we query the referring provider rather than sending a claim we expect to lose. This front-end review is faster and cheaper than appealing after the fact.
ClainetRCM integrates with the platforms radiology practices already use, including Epic Radiant, Merge, Sectra, Nuance PowerScribe, eClinicalWorks, Athenahealth, and AdvancedMD. We adapt to your existing technology rather than forcing a migration, so onboarding does not disrupt your clinical workflow.
Pricing starts at 2.29% of monthly collections, so we are only paid when your practice is paid. There are no setup fees, no long-term contracts, and no hidden charges. Book a free consultation for a quote based on your volume and payer mix.
Ready to Grow Your Radiology Revenue?
Talk to a radiology billing specialist about your prior authorization denials, your component splits, and your AR aging.
Request Your Free Audit TodayLet's Grow Your Radiology Practice
No obligation. Our radiology billing specialists will review your current setup and identify exactly where you are losing revenue.
Why Consult With ClainetRCM?
In a single free session, our radiology RCM experts will uncover hidden billing gaps and give you a clear roadmap to increase collections starting immediately.
Free Revenue Audit
We review your billing performance and identify gaps at zero cost to you.
Dedicated Radiology Billing Expert
You will speak directly with a specialist who understands radiology billing deeply.
100% Confidential
All information shared is protected by HIPAA and never shared with third parties.
Fast Onboarding
Practices go live within 7 to 14 business days of signing on.
No Long-Term Contracts
Pricing starts at 2.29% of collections. No setup fee, no lock-in.