Jurisdiction K Medicare rules shared across Massachusetts, Connecticut, Maine, New Hampshire, New York, Rhode Island, and Vermont, read for Massachusetts claims specifically.
MassHealth's managed care lineup just changed, with Tufts Health Together's MCO ending and two new Mass General Brigham plans taking its place.
Massachusetts never joined the Interstate Medical Licensure Compact, so out-of-state radiologist reads follow the Commonwealth's own licensing path.
Blue Cross Blue Shield of Massachusetts remains the state's largest insurer, running its own claims rules alongside a "reasonable time" prompt-pay standard.
Certified CIRCC and CPC coders handle every CPT code, modifier, and global billing rule specific to diagnostic and interventional radiology — maximizing reimbursement on every encounter across all modalities and payer types.
We manage payer credentialing and enrollment for radiologists, imaging centers, and IR practices. CAQH management and timely revalidations keep providers in-network without delays.
We verify patient coverage and imaging benefits before every scan is scheduled. Our team flags missing prior authorizations and AUC gaps early, preventing denials and protecting your revenue upfront.
We manage your complete revenue cycle — from charge entry and claims submission to payment posting and denial resolution — improving collections and shortening days in A/R.
Our certified coders apply precise CPT and ICD-10 codes across X-ray, CT, MRI, and ultrasound claims. Correct TC/PC/Global splits ensure faster reimbursements and fewer claim rejections.
Our team handles scheduling, patient intake, insurance verification, and pre-authorization coordination so your front desk runs smoothly and imaging appointments stay on track.
We audit your billing and coding processes to uncover missed charges, compliance gaps, and revenue leakage — giving you a clear roadmap to recover lost revenue.
Jurisdiction K's seven-state rules applied without a Massachusetts-specific read
MassHealth MCO assignments billed against plans that already changed
Out-of-state radiologist licenses assumed compact-eligible when they aren't
Chapter 176D's "reasonable time" standard tracked loosely, if at all
Blue Cross Blue Shield's internal claims rules treated like every other payer's
Jurisdiction K guidance applied the way it actually governs Massachusetts claims
Every MassHealth claim checked against the member's current MCO, not last year's
Every reading radiologist's Massachusetts license verified before the claim goes out
Chapter 176D and Chapter 93A exposure tracked on every slow-paying claim
Blue Cross Blue Shield's own claims rules handled on their own terms, not generic ones
Generic billing is the fastest way to a denied radiology claim. RBS delivers specialty-specific revenue integrity built for imaging’s TC/PC splits and modifier rules, so you capture every dollar you’re owed.
Jurisdiction K Medicare expertise, read for Massachusetts
Current MassHealth plan verification on every claim
Massachusetts medical license verification, not a compact assumption
Chapter 176D and 93A tracking on slow-paying claims
Blue Cross Blue Shield of Massachusetts claims rules, handled directly
Radiology Practice Manager
Since partnering with your radiology billing team, our billing workflow has become much smoother. They understand imaging procedures, payer requirements, coding, and claim follow-ups. Their team is responsive, professional, and always stays on top of outstanding claims.
Medical Director, Diagnostic Imaging Center
Your team truly understands the challenges of radiology billing. They handle claims accurately, follow up on unpaid accounts, and help resolve billing issues efficiently. Their expertise and communication have made our revenue cycle more organized and reliable.
Radiologist & Imaging Center Owner
Our team has been an excellent partner for our imaging center. They understand radiology billing, coding, claim submission, denials, and follow-ups. Their attention to detail and consistent communication have helped streamline our billing process and improve our revenue cycle.
