Radiology practices face some of the most complex billing and revenue cycle challenges in healthcare. Our workflows cover every step, from eligibility checks and prior authorizations to CPT/ICD coding, PC/TC splits, and denial management.
HIPAA-compliant, Fort Worth, Texas-based revenue cycle management. Scionis RCM operates under strict data-privacy protocols and standardized billing methodologies aligned to HIPAA requirements, helping US healthcare practices reduce compliance and audit exposure across every specialty we serve.
Even well-run imaging practices lose money from preventable errors that a generalist billing team consistently misses across high study volume.
Professional/Technical (PC/TC) splits billed incorrectly, causing duplicate denials
Interventional radiology bundling errors that fail NCCI edits
Wrong or unspecified ICD-10 codes leading to medical-necessity denials
Missing prior authorization for MRI, CT, and PET studies
Sound familiar? Our systems are built to detect and fix these errors before they impact reimbursement.
Get a Free Radiology AuditScionis RCM builds billing systems that match the actual workflow of your imaging practice. Our team audits every touchpoint in the revenue cycle, closes gaps, and applies the coding and compliance rigor needed to keep revenue steady.
CPT/ICD-10 mapped to ACR guidelines and payer-specific edits, with interventional bundling logic and ongoing accuracy audits.
Proper use of modifiers -26 (professional) and -TC (technical), reducing duplicate claim denials through payer-aligned logic.
Automated tracking for MRI, CT, PET, and interventional cases, with turnaround under 48 hours on most imaging authorizations.
Real-time root-cause tagging (ICD mismatch, missing auth, coding error) and aggressive follow-up for underpaid radiology CPTs like 74177 and 72148.
Weekly dashboards showing denial trends by modality, plus A/R aging reports segmented by payer and CPT category.
Coding and compliance aligned to CMS, payer policy, and No Surprises Act requirements across every modality.
Radiology practices face some of the most complex billing and revenue cycle challenges in healthcare, as outlined by the American College of Radiology (ACR). A single imaging study can be billed as two separate components, prior authorization requirements shift constantly for advanced imaging, and radiopharmaceutical charges are easily lost. Scionis RCM supports imaging centers, radiology groups, and hospitals with comprehensive radiology billing services designed for high-volume, high-denial-risk specialties, covering Diagnostic Radiology, Interventional Radiology, Nuclear Medicine, Breast Imaging, Pediatric Radiology, and Neuro/MSK Imaging, delivered end-to-end.
Across a high-volume imaging practice, a single systematic PC/TC or bundling error doesn't cost one claim — it repeats across every study of that type, which is why subspecialty-level execution protects revenue at scale.
When a radiologist interprets a study performed on equipment they don't own, the professional component (modifier -26) is billed separately from the technical component (modifier -TC). Bill globally when it should be split, or split when it should be global, and the claim denies or duplicates. We apply modifiers -26 and -TC per payer policy and use reconciliation checks to prevent duplicate billing.
Interventional radiology carries complex coding for vascular, oncology, and image-guided procedures. We apply modifier -59 and NCCI edits correctly, ensuring compliance and preventing bundling denials on procedures where generalist billing routinely fails the edits.
MRI, CT, and PET studies increasingly require prior authorization, often managed through radiology benefit managers with their own rules and timelines. We track and process these authorizations within 48 hours, so advanced studies aren't performed against a missing auth. This ties directly into our prior authorization process.
Our real-time root-cause tagging identifies whether a denial stems from an ICD mismatch, a missing authorization, or a coding error, and routes it for correction. We follow up aggressively on underpaid radiology CPTs, reconciling payments against expected values so underpayments on codes like 74177 and 72148 get recovered rather than absorbed. See our full denial management process.
These solutions form the backbone of our radiology RCM services, ensuring clean claims and faster cash flow across diagnostic, IR, nuclear, breast, neuro/MSK, and pediatric radiology.
Radiology billing failures follow predictable patterns, and fixing them produces measurable results. The examples below reflect outcomes published on our radiology practice, alongside the engagement models and performance benchmarks imaging clients can expect.
Issue: High denial rate on MRI lumbar spine (72148) due to missing medical-necessity documentation. Approach: Introduced automated ICD mapping and pre-bill edit checks. Results: a 29% reduction in medical-necessity denials in 90 days and $320K in annual revenue recovered.
Sample outcome as published on the live site — confirm client permission and figures before republishing publicly.
Issue: Frequent duplicate PC/TC denials. Approach: Implemented modifier automation for -26 and -TC. Results: denials reduced by 31% in six months, with first-pass claim rate improved to 95%+.
Sample outcome as published on the live site — confirm client permission and figures before republishing publicly.
Scionis RCM offers a free review of your radiology billing process, identifying overlooked revenue, preventable denials, and systemic gaps across diagnostic, IR, nuclear, breast, neuro/MSK, and pediatric radiology.
As a billing company, we have worked with several RCM vendors, but none have matched the level of service and results we've seen with Scionis RCM. Their technology-driven solutions and expert team have made our processes smoother and more efficient, which has led to increased client satisfaction. They are truly a trusted partner.
Our healthcare network has greatly benefited from the efficient and accurate services provided by Scionis RCM. Their commitment to reducing administrative burden and optimizing our revenue cycle has been a key factor in our growth and success. They are not just a service provider but a vital extension of our team.
Partnering with Scionis RCM has been a game changer for our practice. Their expertise in streamlining revenue cycle management has allowed us to focus on what we do best, caring for our patients. They have significantly reduced our claim denials and improved our cash flow. We couldn't ask for a better partner.
Yes. Our teams are segmented by subspecialty, covering diagnostic, IR, nuclear, breast, neuro/MSK, and pediatric radiology.
We apply modifiers -26 and -TC per payer policy and use reconciliation checks to prevent duplicate billing.
Yes. MRI, CT, and PET authorizations are tracked and processed within 48 hours.
We reconcile radiopharmaceutical orders, supply logs, and HCPCS codes before submission so radiopharmaceutical charges aren't left off claims.
Diagnostic radiology, interventional radiology, nuclear medicine and PET, breast imaging, neuro/MSK imaging, and pediatric radiology.
ICD-10 codes are mapped to ACR guidelines and payer necessity criteria, with pre-bill edit checks that catch mismatches before submission.
Percentage of collections (performance-based) or a fixed monthly fee per FTE for larger practices.
Weekly dashboards showing denial trends by modality, plus A/R aging reports segmented by payer and CPT category.
A closer look at coding workflow optimization for a multi-site radiology group.
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Streamlining the radiology billing workflow to cut split-billing denials.
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How specialty-aligned coding reduced modifier-related denials for an orthopedic surgery group.
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