Radiology Billing Services in Aurora, Colorado

Academic-campus imaging concentrates two problems at once: high advanced-imaging volume that runs through radiology-benefit-manager prior authorization, and complex ownership that forces the professional-technical split. On the Anschutz campus and around it, faculty and subspecialty radiologists read studies performed on university-hospital and children's-hospital equipment — so the read bills under the professional component (modifier 26) while the facility bills the technical component (TC). A freestanding center that owns both bills globally instead. Miss the authorization on an MRI, CT, or PET, or bill a professional read globally, and the claim denies no matter how expert the interpretation. That combination is what a generalist billing company struggles to carry.

Colorado's payer setup governs routing. Colorado Medicaid — Health First Colorado — is organized through Regional Accountable Entities (RAEs) that manage members and coordinate benefits, each with its own prior-authorization and coverage rules, alongside traditional Medicare and its Colorado MAC, Novitas Solutions, whose Local Coverage Determinations govern medical necessity for advanced imaging here. An Aurora radiology claim pays cleanly only when it is routed to the correct RAE or Medicare MAC and coded to that payer's edits.

We bill the full eastern-metro range: academic and subspecialty radiology groups, faculty and hospital-affiliated outpatient radiology, freestanding imaging and diagnostic centers, teleradiology practices reading across state lines, and multi-specialty groups running in-office X-ray, ultrasound, and CT. From the Anschutz Medical Campus across Aurora and the eastern Denver metro — Centennial, Parker, and Commerce City — our medical billing services company handles the whole Health First Colorado, RAE, Medicare, and commercial cycle.