RADPAYOR Computer Assisted Coding
RADPAYOR Computer Assisted Coding
RADPAYOR Computer Assisted Coding


until chaos


Preparing Radiology for ICD-10

What are the ICD-10 PCS codes?

The Big Picture

The Psychology of ICD-10

PQRS RadPayor Video

Frequently Asked Questions*

How does the RadPayor connect to our hospitals and imaging centers?

Short answer: By Hl-7 connections to hospitals HIS, RIS, and PACS.
Details: We are able to connect to most any healthcare computer system. Besides Hl-7, this includes receiving files in the following formats; .txt, .doc, PDF, XML, CSV, and others. If you presently obtain good data we will likely continue that source and format to minimize any disruptions or changes. We have worked with institutions that were still printing reports to paper. When we show them how to save thousands of dollars in printing costs, they are very eager to convert to “print to file” rather than “print to paper”.

What if we already have Hl-7 connections with our hospitals and imaging centers?

We will just use those existing formats to route the data through the RadPayor and then send it on to its original destination within your existing billing system. However the data would already be fully coded and ready to be sent directly to submissions. Rather than the data coming directly from the hospital to your system, it would just make a loop through the RadPayor program and then go on into your system as it does now, but fully coded.

If we want to upgrade our billing software also, do you offer package deals?

Yes. We work closely with billing software companies and can put together package deals where the two systems work seamlessly together with reduced costs.

How much should I budget per procedure for a US based RCCB coder?

Short answer: Ten cents. (U.S. based companies providing RCCB certified coders).
Details: The average United States RCCB RadPayor coder is compensated approximately 10 cents per procedure. This may appear to be unfair compensation by those coders that are not familiar with the RadPayor program. However, with productivity standards at 350 to 500+ procedures per hour you can see that the coder is properly compensated. ($35 to $50 per hour) Those offshore outsourcing companies that are familiar with the RadPayor’s performance also will offer proportionally reduced rates.

How many FTE coders will I need if I utilize the RadPayor?

The average RadPayor coder will code 500,000 procedures per year. Take the yearly number of procedures performed, divide by 500,000, and that will give you an estimate of the number of full time coders needed.

How long has the RadPayor program been utilized in the real world?

The RadPayor program like any software is always in active development. It became a specialty specific program about 7 years ago and is utilized by clients across the states and offshore.

Do you offer coding and/or billing services?

No. We do provide references and referrals to companies and Independent Contractors that utilize the RadPayor and appear to offer reliable quality coding services at competitive prices.

What software or hardware must be purchased to implement the RadPayor?

Only your coders will require a vertically oriented monitor. No other software or hardware is required as the RadPayor is a cloud based service. Users can connect to it using any internet capable device including i-Phones, i-Pads, Kindles and other smart devices. We recommend Dell’s UltraSharp 2007FP or any quality 1600X1200 monitor capable of being used vertically.

Is the RadPayor system designed only for larger radiology groups?

No. It is remarkably scalable. A single coder is all that is necessary to fully utilize the system. However, the system is SQL based and has the ability to allow your coders to process millions of reports per year, including the concurrent interaction of managers, clerks, techs, PACS administrators, and physicians. For all practical purposes there is no upper limit as to what the system can handle.

Does a coder always look at every single report before it is processed as a claim?

Yes, but that is a choice and not a requirement of the system. All of the productivity numbers are reported with a coder reviewing every report. We refer to this as using the program in “Manual Mode”. Some clients may wish to send some studies such as screening mammograms and bone density studies through the system without having it reviewed by a coder. Other clients may allow all of the “Green Lights” to pass through the system without review. It is each client’s choice as to how they wish to utilize the system.

What are the costs?

There is a per procedure charge and a monthly maintenance fee. The “procedure charge” is based upon volume discounts and the maintenance fee is based upon the number of users and interfaces. If your group performs 10,000 procedures per month; then multiply the “procedure charge” times 10,000 and then add the monthly maintenance fee. You will receive an invoice at the end of the second month of using the system which will cover the previous 2 weeks of use. There are no charges for the first 6 weeks of use.

Is the RadPayor only for radiology?

Unfortunately yes. Even though the LCD, NCD, CCI edits, and ICD-10 conversions are universal and the system can process any specialty, the additional programming for RAC violations and etc. is for radiology only. To be the best at what we do, we concentrate only on one specialty.

How can I realistically estimate what I should be able to save by using this system?

Expect it to replace 7 out of every 8 FTE involved in the coding and data entry of radiology reports and patient demographics.
Expect it to replace all of those FTE involved in the gathering, sorting, alphabetizing, scanning, OCR, faxing, emailing, archiving, and retrieving of radiology reports.

Based upon your specific billing software;
Expect to eliminate your “small balance write-offs.” (up to 90%)
Expect to increase your collections.
Expect to reduce your mailing costs (up to 90%)
Conservatively, a group of 8 radiologists is likely to save around $250,000 each and every year, over traditional non-CAC radiology management systems.

What is the expected ROI?

Greater than 400%. Due to a unique payment structure, an “investment” is never required. Invoices for RadPayor services do not start until the end of the second month of utilizing the system, with the first 6 weeks of use being free. This allows your company to start accruing the cost savings of utilizing the software before you start to pay for its use. The savings are greater than the cost of the RadPayor services by a factor of at least 400%, but again there is no investment involved. It’s like having already saved 6 dollars last month, at a cost of $1 today, rather than paying today for a promise of saving $6 next month.

What is the duration of your average contract and is there an early get-out penalty if I am unhappy with your services?

The duration of the standard contract is 1 year and one day to satisfy CMS guidelines. However normally you may end the contract without cause and without penalty by providing a 30 day prior written notice.

Do offshore outsourcing services utilize the RadPayor?

Yes. However, expect to pay less than 1/8th the normally quoted rates. The “manager’s report” can be utilized as a substantial negotiating tool to obtain very competitive contracts. Contact us for referrals and references.

Can the RadPayor handle large high volume groups?

Yes. The RadPayor allows many coders to work within the same account simultaneously. (as well as managers, physicians, etc). This allows a single large 100+ radiology group, capable of several million procedures per year, to be easily handled by the RadPayor system. The RadPayor can essentially handle an unlimited number of individual separate radiology groups. An SQL enterprise database structure is utilized.

What do you mean when you say; “Based upon your specific billing software; Expect to eliminate your “small balance write-offs.””

The RadCheck-In and RadVerifier modules allow the calculation of “pt. owes,” so any balance can be collected at the time services are delivered. If this is not possible, the modules collect patients’ email and txt messaging information, allowing patients to be notified electronically of online payment options which are then auto-posted when received. This allows the collection of “small balance write-offs” to be performed entirely electronically and thus economically. Yes, it can also be used to send out all statement notices if you wish, thus almost eliminating your mailing costs while offering your patient’s the convenience of online payments, (improving collections and stopping the automatic loss of “small balance write-off” revenue)

As an imaging center do I need to worry about the ICD-10-PCS codes?

No. The ICD-10-PCS codes are used on inpatient procedures only. Only rarely should you get a referral that references the ICD-10-PCS if systems are functioning correctly.

Our radiologists perform needle biopsy procedures and over-reads on fluoroscopic guided procedures performed by general surgeons at the hospital. Do I need to worry about the ICD-10-PCS codes?

Yes. These procedures will sometimes be performed on hospitalized “inpatients” and would need to be dictated appropriately to allow coding in the ICD-10-PCS format. The actual radiology report may contain either the ICD-10-PCS or CPT coding or both. For you to file a claim for the radiologist’s services however, you must use the CPT coding format.

What are the “unspecified codes”?

Certain codes in ICD-9 are termed “unspecified”. “Chest pain” (R079) and “abdominal pain” (R109) are good examples of “unspecified codes” that are used daily in substantiating medical necessity. (payable diagnosis). Such codes are considered too general and not very specific. Presently in ICD-9, the “unspecified” codes can be used to substantiate medical necessity as there is no blanket rule preventing their use. It is highly rumored that with the implementation ICD-10, CMS will no longer allow the use of the “unspecified” codes. Allowing the use of “unspecified” codes would erode the primary benefit of the ICD-10 format, which is much greater specificity. In ICD-10 coding, all of the “unspecified codes” end in either a zero or nine. If CMS or others decided not to allow “unspecified codes”, they will not pay on those claims supported by the ICD-10 codes ending in a zero or nine.

*(the above discussions are based on general radiology groups performing mostly diagnostic studies. Coding a high percentage of interventional studies will produce slower performance standards)

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