Radiology billing · Clovis, CA
Radiology Billing Services in Clovis, California
Radiology billing services in Clovis operate in a Central Valley market where Medi-Cal covers a large share of the imaging population and every advanced study still has to clear a benefit manager and a Noridian medical-necessity edit before it pays.
247MBS has billed imaging since 2005: dedicated account manager, free performance dashboard, HIPAA-compliant and SOC 2 Type II, splitting each Clovis CT, MRI, and PET into its professional and technical parts and routing it to the right California payer.
Radiology Billing Services in Clovis for Every Practice
Clovis sits in the Fresno metro, and its payer mix reflects the Central Valley: a heavy Medi-Cal share alongside Medicare and commercial coverage. That mix rewards a billing operation that knows the managed-care Medi-Cal rules cold, because a large slice of imaging volume rides on plans whose authorization and coverage edits are unforgiving of a claim built for the wrong payer.
Two payer realities set the terms. California's Medicaid program, Medi-Cal, delivers most benefits through managed care — in the Fresno area largely via the local plan (CalViva Health) working with its delegated networks — each carrying its own prior-authorization and coverage rules. Traditional Medicare Part B in California sits under Noridian Healthcare Solutions (Jurisdiction E), whose Local Coverage Determinations govern medical necessity for advanced imaging. A Clovis claim clears only when it is aimed at the correct Medi-Cal plan or the Noridian MAC and coded to that payer's edits.
How radiology claims get paid
Codes below only illustrate the mechanics our team runs on each Clovis study; they stay in the table, not the copy.
| Study or element | How it's billed | What drives payment |
|---|---|---|
| MRI lumbar spine w/o contrast (72148) | Prior auth, then 26 / TC or global | RBM authorization before the scan |
| CT head w/o contrast (70450) | Global, or split by ownership | Who owns the scanner vs the read |
| PET oncologic (78815) | Advanced imaging, LCD-governed | Medical necessity per Noridian JE policy |
| US abdomen complete (76700) | Global or split | Site of service and ownership |
| Read on hospital equipment (26) | Professional component, modifier 26 | Radiologist interprets; facility bills TC |
| Repeat / bilateral study | Modifiers 76 / 77, RT / LT | Documented re-read or laterality |
The workflow carries a 99% clean-claim rate, roughly 99% net collections, A/R under 25 days, up to 40% fewer denials, and 90% denial recovery, with claims submitted inside 24 hours.
Where Clovis radiology practices lose revenue
a rejection when the managed-care enrollment wasn't verified against the assigned plan before the study.
a professional read billed globally, or a technical charge duplicated against a hospital-based interpretation.
components billed together the edits pay separately, or a re-read filed without modifier 76 or 77.
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 Clovis, 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
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 Clovis practices outsource radiology billing to 247MBS
Practices here outsource radiology billing because a Medi-Cal-heavy book — managed-care plans and their authorization rules stacked on the 26/TC split and Noridian LCDs — is more than a general billing company carries well. As a medical billing services company built around imaging, we already run the RBM workflow and the necessity checks before your first claim. When you outsource to us, the queue clears before submission:
- Eligibility and payer verification — the active Medi-Cal plan, Medicare, or commercial coverage and its auth requirement confirmed pre-scan
- Denial management and appeals — worked against the LCD and authorization record, not blindly resubmitted
- A/R follow-up — aged Medi-Cal and commercial imaging balances pursued to resolution
It all runs inside our radiology revenue cycle practice — one professional team, one dashboard, a 98% retention rate.
Who we serve in Clovis
We bill hospital-based radiology groups reading for the Fresno-Clovis facilities, freestanding MRI and CT centers, outpatient and mobile imaging operators, orthopedic and women's-health practices running in-office studies, and teleradiology groups covering Clovis, Fresno, Sanger, Madera, and the surrounding Central Valley communities. Own the equipment, only the read, or both — we bill the professional and technical components to match.
Medical Billing for Radiology in Clovis
Turning a Medi-Cal-heavy imaging book into first-pass payment is what medical billing for radiology in Clovis is really about, and 247MBS runs the Central Valley playbook that makes it happen. We confirm each patient's CalViva Health or other assigned Medi-Cal managed-care plan before the scan, secure benefit-manager authorization on advanced studies, and match every diagnosis to Noridian JE medical-necessity policy so a completed read does not die on a coverage edit. Fresno-Clovis hospital groups, freestanding centers, and mobile operators keep more of every MRI, CT, and PET dollar when the claim is built for the right payer up front. Request a revenue review and see what a Valley-tuned imaging team recovers.
Choosing a Radiology Billing Services Provider in Clovis
Let's get your Clovis radiology claims paid faster
Start with a revenue review: we'll review your Medi-Cal authorizations, your Noridian LCD matches, your 26/TC splits, and your aging A/R, then show what professional radiology billing can recover.
Radiology billing across California
Clovis practices are billed out of the same California desk. Statewide payer detail lives on the California page.
California Radiology billing services — the payer programs, authorities and rules behind every Clovis claim.
Outsourcing Radiology Billing Services — the codes, unit rules and denials nationally, without the local layer.
FAQ
It concentrates the work in managed-care rules. We verify the patient's assigned Medi-Cal plan and its prior-authorization requirement before advanced imaging, so a Medi-Cal-heavy book doesn't turn into a denial-heavy one.
California Part B runs under Noridian JE. We match the ordering diagnosis to the covering Noridian LCD before the study bills, so it isn't denied on medical necessity after the read.
Yes. We confirm the reading radiologist's licensure and enrollment and apply repeat-read modifiers 76 and 77 when a study is legitimately re-read.
Ready to get more Clovis claims paid on the first pass?
From solo practices to multi-provider groups, we bill Radiology for Clovis 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