Most radiology services have two components: the technical component (the equipment, facility, and technologist who performed the imaging) and the professional component (the radiologist's interpretation and report). When the same entity provides both, billing is typically global. When the radiologist and the imaging facility are separate — as in teleradiology arrangements, hospital-based groups, or multi-site operations — each entity bills its respective component. Getting this wrong produces either a duplicate claim rejection, a component mismatch denial, or systematic underpayment when the global rate is applied where only one component is appropriate. PerfectMBS maps the correct billing arrangement for every site and payer relationship and maintains it as those arrangements change.

We treat prior authorization as a front-end revenue protection function, not a back-office task. Every advanced imaging order — MRI, CT, PET, nuclear medicine — is verified for authorization requirement before the study is scheduled. We submit the auth request, follow up until a determination is received, and confirm the authorization against the specific CPT code, facility, and expiration date before the patient arrives. We do not allow studies to proceed without a confirmed authorization in place. When authorization is denied, we appeal with clinical documentation and ordering physician support immediately. An authorization denial before the scan is an administrative problem we can fix. An authorization denial after the scan is an almost always unrecoverable revenue loss.

Prior authorization failures account for approximately 35% of radiology denials — the single largest category. Medical necessity denials follow, typically when the ordering diagnosis does not meet the payer's clinical criteria for the imaging study requested. Component billing errors generate a third major denial category, particularly in practices with multiple sites, changing facility arrangements, or teleradiology operations. Credentialing gaps — claims submitted under a radiologist's NPI before payer enrollment is confirmed — produce full claim denials that accumulate quickly in high-volume practices. Each of these categories has a specific resolution and a specific upstream process fix. PerfectMBS addresses all four.

Yes. The billing requirements for freestanding imaging centers and hospital-based radiology departments differ in several important ways — facility fee billing, outpatient hospital rate structures, HOD (hospital outpatient department) versus ASC versus physician office place of service distinctions, and the interaction between the facility's UB-04 claim and the professional component CMS-1500 claim in split billing arrangements. PerfectMBS manages both environments and handles the coordination between facility billing and professional billing to ensure claims do not overlap, duplicate, or leave component gaps that produce denials on either side.

Within the first 30 days, your claims are submitting under the correct component configuration, your prior authorization workflow is in place, and your existing denial backlog is being triaged and worked in priority order. By day 60, the denial rate should be showing early improvement as front-end process fixes take effect and the appeal pipeline works through aged denials. By day 90, you have three months of baseline performance data — denial rate by modality and payer, clean claim rate, auth approval rate, and underpayment recovery totals — showing measurable movement against where you started. If we are not producing visible improvement by day 90, we will tell you what is holding it back and what we are changing.