RSNA2021 Redefining Radiology
Daily Bulletin



One-Third of Radiology Patients Termed Self-Pay at Registration Actually Have Billable Coverage

Wednesday, Dec. 01, 2021

By Richard Dargan

Redefining Radiology, the theme of RSNA 2021, centers around reducing inequities in patient care and inefficiencies in radiology practices.

Juli Smith


Those initiatives have particular relevance to the billing process, where errors and miscommunication often leave both providers and patients frustrated.

Billing problems have been exacerbated in recent years by two pressure points: government regulations and payer tactics that place more responsibility for out-of-pocket expenses on the patient. In this environment, identifying possible coverage for self-pay patients and capturing maximum reimbursement for all services rendered can be a challenging, labor-intensive process.

“When providers like radiologists are ancillary to a hospital, they have a real struggle getting good information surrounding the patient,” said Juli Smith, director of ZOLL® Data Systems, a Broomfield, Colorado-based healthcare software solutions company. “They often don’t have the very information that is required to get a clean claim out the door and for reimbursement.”

Challenges frequently arise early in the patient encounter. Information that the patient provides at the time of registration to the hospital has errors more than 60% of the time, according to Smith. Something as simple as a transposition of a date of birth can lead to the denial of a claim.

Additionally, patients who forget their insurance card are often incorrectly checked in as self-paying. Almost a third of patients who are noted as self-pay at the time of registration actually have active billable coverage, according to Smith.  The struggle is that the coverage is hidden to the provider leaving the provider in a difficult position.

These and other billing challenges make data management software products like ZOLL AR Boost®, ZOLL Data Systems’ real-time accounts receivable (AR) optimization solution, essential for today’s radiology providers. By correcting patient information on the front-end and revealing previously hidden coverage, ZOLL AR Boost helps ensure that no payments are left on the table. It delivers self-pay analytics, demographic verification, insurance discovery and verification in a matter of seconds, freeing staff from having to enter or search for data manually.

“In our studies, we’ve seen that utilizing tools like these reduces the administrative burden for the billing component by about 30%,” Smith said.

Visit Zoll Data Systems AR Boost at Booth 1603 during RSNA 2021.