Leak
Global fee billed on a hospital-based read
The denial it triggers
Overpayment recoupment
How we stop it
We bill modifier 26 wherever the facility owns the equipment
Radiology billing · Allentown, PA
Radiology Billing Services in Allentown, Pennsylvania
Radiology billing services in Allentown come down to one recurring question — who owns the scanner — because in a market dominated by Lehigh Valley Health Network and St.
Luke's, most reads are hospital-based and must be split. 247MBS has billed radiology since 2005: dedicated account manager, free dashboard, HIPAA-compliant, SOC 2 Type II, aligned to HealthChoices and Novitas LCDs.
HIPAACompliant
SOC 2Type II
Serving Since2005
Specialty-FocusedRCM
We bill Radiology for Allentown practices
Diagnostic Imaging
CT & MRI
Ultrasound
Interventional
Mammography
And More
Best Radiology Billing Services in Allentown, PA
The Lehigh Valley's imaging landscape is shaped by two large systems and the independent radiologists who read alongside them. When your group interprets a study performed on hospital equipment, you bill only the professional component — modifier 26 — while the facility bills the technical side under TC. Bill that same read globally, as if you owned the scanner, and Medicare or the commercial plan claws the difference back as an overpayment. Getting the site of service right on every claim is the single biggest protector of an Allentown practice's collected revenue.
Pennsylvania's payer setup adds the next layer. Medicaid here runs through HealthChoices, the state's managed-care program, so the plan that authorizes advanced imaging shifts patient to patient and has to be verified against live eligibility. For Medicare Part B, Pennsylvania sits under Novitas Solutions (JL), whose Local Coverage Determinations govern medical necessity. Neither the interpretation's quality nor the referral saves a claim that misses those gates.
0%
First-pass clean-claim rate
0%
Net collections
up to 0%
Fewer denials
<0
Days in A/R
~0 of 10
Worked denials overturned on appeal
0%
Client-retention rate
How radiology claims get paid
An Allentown study pays only when each of these is set correctly.
| Billing element | How it drives payment in Allentown |
|---|---|
| Site of service | Hospital-based read splits the claim; office ownership bills global |
| Professional vs technical | Modifier 26 for the read, TC for equipment; global only when one entity owns both |
| Prior authorization | MRI/CT/PET cleared through the plan's radiology-benefit manager first |
| LCD / medical necessity | Diagnosis matched to the covering Novitas JL policy |
| Contrast and supervision | With/without-contrast codes and supervision level tied to the order |
| Modifiers | RT/LT laterality, 59 to unbundle, 76/77 for legitimate repeats |
The numbers behind the workflow: a 99% clean-claim rate, roughly 99% net collections, A/R under 25 days, up to 40% fewer denials, and 90% of denials recovered, with claims out within 24 hours.
Where Allentown radiology practices lose revenue
Leak
No RBM prior auth on advanced imaging
The denial it triggers
Non-appealable denial
How we stop it
We secure the authorization before the scan
Leak
LCD / medical-necessity mismatch
The denial it triggers
Novitas edit denies the study
How we stop it
We match diagnosis to the covering LCD up front
Leak
NCCI bundling
The denial it triggers
Professional read denied as included
How we stop it
We unbundle with modifier 59 only where genuinely distinct
Leak
Duplicate same-day reads
The denial it triggers
Second interpretation rejected
How we stop it
We apply 76/77 to defend real repeats
Your revenue review shows which of these is quietly costing your Allentown practice the most.
Revenue review
Put a dollar figure on what your radiology claims are leaving behind.
A certified radiology billing specialist reviews your coding, unit counts, authorizations and aged A/R against the payers you actually bill in Allentown, PA — and puts a number on what your current process is leaving on the table.
- Professional and technical components billed to the right entity per site
- Advanced-imaging authorization confirmed before the study is read
- Contrast, laterality and comparison-study modifiers checked per payer
HIPAA & SOC 2
Back to you within one business day
No long-term lock-in
Request a Revenue Review
Tell us about your practice.
A radiology specialist will reach out within one business day.
Thanks — we’ve got it.
A radiology specialist will reach out within one business day.
Why Allentown practices outsource radiology billing to 247MBS
Groups here outsource radiology billing because the hospital-based split, the HealthChoices auth map, and the Novitas LCDs reward a specialist and punish a generalist. A general billing company learns the 26/TC rule on your denied claims; as a medical billing services company built around imaging, we already carry it. We run the whole cycle:
- Eligibility and payer verification — the exact HealthChoices plan or commercial coverage and auth status confirmed pre-scan
- Denial management and appeals — worked against the LCD and site-of-service record, not just resubmitted
- Insurance credentialing — radiologists paneled across Pennsylvania Medicaid plans and commercial carriers
- A/R follow-up — aged imaging balances chased to resolution
It all runs inside our radiology revenue cycle practice — one team, one dashboard, a 98% retention rate.
Who we serve in Allentown
We bill hospital-based radiology groups reading for the Lehigh Valley systems, freestanding imaging and diagnostic centers, outpatient and mobile MRI/CT operators, interventional radiology practices, and teleradiology groups covering Allentown, Bethlehem, Easton, and the surrounding Lehigh Valley. Own the equipment, only the read, or both — we bill the professional and technical pieces to match.
Medical Billing for Radiology in Allentown
Keep more of every Lehigh Valley read on the books — 247MBS handles medical billing for radiology in Allentown so your professional interpretations, not the hospital's equipment charges, land clean the first time. Because most groups here read on Lehigh Valley Health Network and St. Luke's scanners, we split each claim to the correct site of service, verify the covering HealthChoices managed-care plan before the study, and match every diagnosis to the Novitas JL coverage policy that governs it. Since 2005 we have held a 99% clean-claim rate and A/R under 25 days for imaging clients across the region. Request a revenue review and see exactly where your Allentown collections are leaking.
Choosing a Radiology Billing Services Provider in Allentown
Let's get your Allentown radiology claims paid faster
Start with a revenue review: we'll review your 26/TC splits, your advanced-imaging authorizations, your Novitas LCD matches, and your aging HealthChoices A/R, then show you what professional radiology billing can recover.
Radiology billing across Pennsylvania
Allentown practices are billed out of the same Pennsylvania desk. Statewide payer detail lives on the Pennsylvania page.
Statewide
Medical billing for Radiology practices in Pennsylvania — the payer programs, authorities and rules behind every Allentown claim.
Specialty hub
Radiology Billing Services Outsourcing — the codes, unit rules and denials nationally, without the local layer.
FAQ
Yes, that split is the heart of radiology billing here. Your radiologists' interpretations bill with modifier 26 while the facility bills the technical component, and we never let a global fee slip through in a provider-based setting where it would be recouped.
We verify the active HealthChoices managed-care plan through live eligibility before the study and route the claim to the plan that will actually pay, rather than assuming the coverage from a prior visit still holds.
Yes. We secure the radiology-benefit-manager authorization before the scan runs, because advanced-imaging denials are frequently non-appealable once the study is complete.
26 / TC split·place of service·prior authorization·laterality
Ready to get more Allentown claims paid on the first pass?
From solo practices to multi-provider groups, we bill Radiology for Allentown practices with a dedicated account manager, certified coders and a live dashboard — so the units, authorizations and appeals that decide your month stop being the thing nobody has time for.
Prefer email? sales@247medicalbillingservices.com