MRI, CT, and PET sent before a radiology-benefit manager cleared them; the single biggest uncollectible in this market.
Radiology billing · Antioch, CA
Radiology Billing Services in Antioch, California
For an East Bay imaging practice, radiology billing services in Antioch succeed or fail at the prior-authorization gate — and that is where 247 Medical Billing Services starts.
In a Contra Costa County market where most patients sit inside Medi-Cal managed care and commercial plans push advanced imaging through radiology-benefit managers, an MRI, CT, or PET that goes out without authorization is money you will never see. We secure the auth, split the professional and technical components correctly, and bill each study to the right California payer. You get a dedicated account manager, a free performance dashboard, HIPAA and SOC 2 Type II compliance, and a billing partner working this way since 2005.
HIPAACompliant
SOC 2Type II
Serving Since2005
Specialty-FocusedRCM
We bill Radiology for Antioch practices
Diagnostic Imaging
CT & MRI
Ultrasound
Interventional
Mammography
And More
Radiology Billing Services in Antioch for Every Practice
The Antioch payer mix is heavily Medi-Cal. California runs Medi-Cal largely through managed-care plans, and in Contra Costa that means the county's own Contra Costa Health Plan alongside commercial Medi-Cal MCPs, each with distinct prior-authorization and coverage rules — plus traditional Medicare and its California MAC, Noridian Healthcare Solutions, whose Local Coverage Determinations govern medical necessity for advanced imaging here. A radiology claim in Antioch pays cleanly only when it is routed to the right one of those payers and coded to that payer's edits. That is a level of California-specific routing a generalist radiology billing company simply does not carry.
Underneath the routing sits the split that defines radiology everywhere: who read the study versus who owns the scanner. A freestanding Antioch imaging center that owns both bills the study globally; when an independent radiologist reads a scan performed on a facility's equipment, the read bills under the professional component (modifier 26) and the facility bills the technical component (TC). Site of service drives that decision, and getting it wrong turns a clean interpretation into a duplicate or mismatched-split denial.
Where Antioch radiology practices lose revenue
the ordering diagnosis does not meet the Noridian coverage determination, so the read denies.
a professional read billed globally, or a technical charge duplicated against a separate read.
components or add-ons billed in combinations the edits reject.
a repeat interpretation submitted without modifier 76 or 77 to show it was a genuine re-read.
How radiology claims get paid
Codes appear only to illustrate the mechanics our team runs on every Antioch study.
| Study or element | How it's billed | What drives payment |
|---|---|---|
| Advanced MRI, e.g. lumbar spine (72148) | Prior auth, then 26 / TC or global | RBM authorization before the scan |
| CT chest (71260) | Global, split by ownership | Who owns scanner vs read; site of service |
| PET scan (78815) | Advanced imaging, LCD-governed | Medical necessity per Noridian LCD |
| Abdominal ultrasound (76700) | Global or split | Component ownership; supervision met |
| Diagnostic mammography (77066) | Global or technical | Diagnostic-vs-screening intent, frequency |
| Repeat / bilateral study | Modifiers 59 / 76 / 77, RT / LT | Distinct, repeat, or laterality documented |
| Contrast and supervision | Bundled or separately reported | Supervision level and contrast rules |
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 Antioch, CA — 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.
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A radiology specialist will reach out within one business day.
Why Antioch practices outsource radiology billing to 247MBS
Advanced-imaging-heavy practices are exactly where outsourcing to a professional, radiology-fluent team earns its keep. When you outsource to 247MBS, the authorization queue, the 26/TC decision, and the LCD check all clear before a claim leaves the building. We run eligibility and payer verification to confirm the exact Medi-Cal managed-care plan or Medicare MAC per patient, denial management and appeals worked to root cause, and A/R follow-up that pursues aged imaging balances to resolution. Our compliant numbers — 99% clean-claim rate, roughly 99% net collections, A/R under 25 days, up to 40% fewer denials, 90% of denials recovered — get measured against your own claims in the audit. Everything runs inside our radiology revenue cycle practice: one team, one account manager, one dashboard, backed by 98% client retention.
Who we serve in Antioch
We bill the full East Bay range: freestanding imaging and diagnostic centers, independent radiology reading groups, hospital-affiliated outpatient radiology, teleradiology practices reading across state lines, and multi-specialty groups running in-office X-ray, ultrasound, and CT. From Antioch across Contra Costa County — Brentwood, Pittsburg, Oakley, and Concord — our medical billing services company handles the whole Medi-Cal, managed-care, Medicare, and commercial cycle.
Medical Billing for Radiology in Antioch
Clear the prior-authorization gate before a scan ever runs — that is what medical billing for radiology in Antioch has to do first, and it is where 247MBS starts. In an East Bay market where most patients sit inside Medi-Cal managed care and commercial plans push advanced imaging through radiology-benefit managers, we secure the authorization up front, route each study to the correct plan including Contra Costa Health Plan, and match the ordering diagnosis to the covering Noridian policy. We settle the professional-technical split by site of service so nothing bills as a duplicate. Since 2005 our imaging clients have held a 99% clean-claim rate and A/R under 25 days. Request a revenue review.
Choosing a Radiology Billing Services Provider in Antioch
Radiology billing across California
Antioch practices are billed out of the same California desk. Statewide payer detail lives on the California page.
Statewide
Radiology billing services in California — the payer programs, authorities and rules behind every Antioch claim.
Specialty hub
Radiology Billing company — the codes, unit rules and denials nationally, without the local layer.
FAQ
We treat prior authorization as step one, not an afterthought. Before an MRI, CT, or PET is performed, we secure the radiology-benefit-manager authorization the plan requires and confirm the ordering diagnosis meets the Noridian LCD. An unauthorized advanced scan is uncollectible, so closing that gap is usually the first revenue we recover.
Medi-Cal through its managed-care plans, including Contra Costa Health Plan and the commercial MCPs serving the county, plus Medicare and its MAC (Noridian) and your commercial carriers. We verify the active plan through eligibility before every claim.
Yes. When one Antioch entity owns both the scanner and the read, we bill globally; when a radiologist reads a study performed on someone else's equipment, we bill the professional component under modifier 26 and let the facility bill the technical component under TC.
Yes — we confirm the reading radiologist's multi-state licensure and payer enrollment and apply repeat-read modifiers 76 and 77 when a study is re-read.
26 / TC split·place of service·prior authorization·laterality
Ready to get more Antioch claims paid on the first pass?
From solo practices to multi-provider groups, we bill Radiology for Antioch 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