Radiology billing · Des Moines, IA
Radiology Billing Services in Des Moines, Iowa
Radiology billing services in Des Moines answer to Iowa's fully privatized Medicaid — nearly every Medicaid member sits with an IA Health Link managed-care plan — alongside UnityPoint and MercyOne commercial volume and WPS medical-necessity rules.
247MBS has billed radiology since 2005: a dedicated account manager, a free dashboard, HIPAA-compliant and SOC 2 Type II, with every Des Moines CT, MRI, and PET matched to the covering plan and LCD before it pays.
Radiology Billing Services in Des Moines for Every Practice
As Iowa's capital and largest metro, Des Moines carries the state's biggest imaging market, built around UnityPoint Health and MercyOne along with freestanding centers and interventional groups serving Polk County and the surrounding suburbs. Most professional reads happen inside hospitals the radiologist doesn't own, so modifier 26 rides the interpretation while the technical component follows the equipment. In a provider-based department, billing that split wrong triggers a recoupment; setting it correctly gets the read paid the first time.
Iowa's Medicaid setup is distinctive. Iowa runs its Medicaid almost entirely through managed care — the IA Health Link program, where members enroll with contracted managed-care organizations that own eligibility and authorization. So the plan responsible for a patient, and its radiology-benefit manager, changes case to case. For Medicare Part B, Iowa sits under Wisconsin Physicians Service (J5), whose Local Coverage Determinations decide which diagnoses make a study medically necessary. Miss the IA Health Link authorization or the WPS LCD match and the read denies no matter how strong the interpretation was.
How radiology claims get paid
Every Des Moines study is a chain of billing decisions our team owns from order to remittance.
| Billing element | How it drives payment in Des Moines |
|---|---|
| MCO plan verification | The member's IA Health Link plan confirmed before the scan |
| Prior authorization | MRI/CT/PET cleared through the plan's RBM first |
| Professional vs technical | Modifier 26 for the read, TC for equipment; global only when one entity owns both |
| Site of service | Hospital-based read splits the claim; office ownership bills global |
| LCD / medical necessity | Diagnosis matched to the covering WPS J5 policy |
| Modifiers and supervision | RT/LT, contrast/supervision level, 59 to unbundle, 76/77 for legitimate repeats |
Those decisions sit behind the numbers that matter: a 99% clean-claim rate, roughly 99% net collections, under-25-day A/R, up to 40% fewer denials, and 90% of denials recovered on appeal, with claims out the door inside 24 hours.
Where Des Moines radiology practices lose revenue
Revenue here rarely walks out the front door — it drips through preventable edits:
Your revenue review ranks these by dollars lost across your Des Moines sites, so the biggest leak gets fixed first.
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 Des Moines, IA — 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
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Why Des Moines practices outsource radiology billing to 247MBS
Groups here outsource radiology billing because a general billing company treats an imaging claim like any office visit — and Iowa's all-MCO Medicaid makes that costly. As a medical billing services company built specifically around imaging, we carry the IA Health Link verification, the RBM authorizations, the WPS LCD map, and the component-split logic before your first claim goes out. We run the full cycle:
- Eligibility and payer verification — the member's IA Health Link plan or commercial coverage and auth requirement confirmed pre-scan
- Denial management and appeals — worked against the LCD and plan routing, not just resubmitted
- Insurance credentialing — radiologists paneled across Iowa's MCOs and commercial carriers
- A/R follow-up — aged Medicaid and commercial imaging balances pursued until they clear
All of it lives inside our radiology revenue cycle practice — one accountable team, professional imaging coders, and a free dashboard, backed by a 98% retention rate.
Who we serve in Des Moines
We bill hospital-based radiology groups reading for the UnityPoint and MercyOne systems, freestanding MRI and CT centers, outpatient and mobile imaging operators, interventional radiology practices, and teleradiology groups covering Polk County and central Iowa — from West Des Moines and Ankeny to Urbandale, Ames, and Waukee. Whether you own the equipment, only the read, or both, we bill the professional and technical pieces to match.
Medical Billing for Radiology in Des Moines
Imaging groups across Polk County keep more of what they earn when medical billing for radiology in Des Moines is handled by a team fluent in Iowa's all-managed-care Medicaid. We bill every UnityPoint and MercyOne read, plus the freestanding CT, MRI, and interventional volume across the metro, against the right payer — the member's IA Health Link plan, a commercial carrier, or Medicare. Our coders confirm the responsible managed-care organization before the scan, set the professional-and-technical split by site of service, clear radiology-benefit-manager authorization first, and match each diagnosis to the covering WPS Jurisdiction 5 policy. That routing discipline holds A/R under 25 days at a 99% clean-claim rate. Request a revenue review to see what your reads should collect.
Choosing a Radiology Billing Services Provider in Des Moines
Let's get your Des Moines radiology claims paid faster
Start with a revenue review: we'll review your IA Health Link verification, your advanced-imaging authorizations, your 26/TC splits, and your aging Iowa Medicaid A/R, then show you what professional radiology billing can recover.
Radiology billing across Iowa
Des Moines practices are billed out of the same Iowa desk. Statewide payer detail lives on the Iowa page.
Iowa Radiology billing — the payer programs, authorities and rules behind every Des Moines claim.
Outsource Radiology Billing — the codes, unit rules and denials nationally, without the local layer.
FAQ
We identify the member's IA Health Link MCO before the study and confirm its authorization rules, so the read routes to the plan responsible for that patient rather than being denied for going to the wrong one.
Yes. Iowa's Medicare Part B claims run under WPS J5, and its Local Coverage Determinations govern medical necessity. We check the ordering diagnosis against the covering policy before the read goes out.
Yes. We set the professional/technical split per site of service — modifier 26 where you only interpret, global where you own the equipment and the read — so neither claim is over- or under-billed.
Ready to get more Des Moines claims paid on the first pass?
From solo practices to multi-provider groups, we bill Radiology for Des Moines 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