A radiology claim can appear accurate and still fail at adjudication. A mismatched authorization, unsupported diagnosis, incorrect modifier, missing report detail, or payer-specific edit can delay reimbursement for weeks. HMS USA Inc helps radiology organizations address these problems before submission by connecting front-end verification, documentation, coding, claim...
Denied claims do more than delay reimbursement. They increase administrative work, weaken cash flow, and create revenue that many practices never recover. Across healthcare organizations, unresolved denials have been associated with an average annual loss of $5 million, or nearly 5% of net patient revenue. Initial denial rates also increased from 9% in 2016 to 12% in 2022.
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