For years, most podiatrists have focused on documenting why an X-ray was medically necessary and ensuring that an interpretation was included in the patient’s medical record.

Unfortunately, for some insurance companies, that’s no longer enough.

We’re seeing an increasing number of payers request the actual X-ray images as part of pre-payment reviews, post-payment audits, and appeals involving payment recoupments (“takebacks”). In some cases, simply documenting that X-rays were obtained and interpreted may not satisfy the payer. They want proof that the study was actually performed. Medicare and commercial payers also have the authority to request additional documentation during claim reviews, making it critical that practices can promptly produce supporting records when requested.

Protect Your Practice

Take a few minutes to review your current workflow:

•  Verify that your digital X-ray system securely stores all images for the required record retention period.
• Confirm that your staff knows how to quickly retrieve and export X-ray images when an insurance company requests them.
•  Make sure your documentation clearly supports the medical necessity for obtaining the X-rays and includes your interpretation.
• If your digital X-ray system is not interfaced with your EHR, determine the easiest method for submitting images with claims or appeals. In many practices, this means taking screenshots of the appropriate X-ray views, scanning or saving them as image or PDF files, and uploading them with the supporting documentation.
• Establish a written protocol so your billing team knows exactly how to respond when an insurance company requests radiographic images.

The Bottom Line

Insurance companies continue to expand their documentation requirements in an effort to validate services before or after payment. Practices that can quickly produce both their documentation and the corresponding X-ray images are in a much stronger position to prevent payment delays, successfully defend appeals, and reduce costly takebacks.

Don’t wait until you receive an audit letter or overpayment request. Make sure your practice can retrieve and submit X-ray images just as easily as your chart notes. That extra preparation could save thousands of dollars in recovered payments.