Diagnostic Imaging Integrated Patient Payments Software

Integrated Patient Payments in a Diagnostic Imaging Practice

Imaging payments come at three points. Self-pay patients often pay before the scan, against a good faith estimate or a cash price. Insured patients with a deductible owe after the claim pays, and that balance can be large for an MRI, CT or PET/CT. Some patients need to spread that cost over time. Integrated patient payments handle all three in one place. At booking, staff take a self-pay payment or a deposit tied to the estimate. After the payer pays, a stored card can be charged with the patient's consent, or a text link goes out with the final amount. Large balances move to a payment plan that drafts on a set date. Card data is held as a token by the payment gateway. Each payment posts to the patient's account and to the right study, so the imaging center, the reading group and the patient all see the same balance.

Why Is Integrated Patient Payments Different in Diagnostic Imaging?

Imaging has more self-pay and shopping patients than most services. Patients with high deductibles compare cash prices for an MRI or CT before they book. Many will pay up front if the price is clear and the payment is easy. The practice needs to take that money at booking and tie it to the estimate, so the final bill closes cleanly and no credit is left sitting on the account.

Collecting at the wrong moment causes refunds and anger. A front desk that collects a flat copay at check-in may charge a Medicare patient for a screening mammogram that carries no cost share. A deposit for a contrast MRI may be too high once the payer allows the claim. The safer path for insured patients is to collect after the claim pays. A card on file, stored with consent, makes that easy without a second phone call.

Large balances need a path the patient can live with. A PET/CT or a multi-area MRI can leave a deductible balance a patient cannot pay at once. A payment plan that drafts on schedule keeps the account current without staff chasing each amount. Integrated patient payments tie every plan draft and card charge to the same balance shown on imaging patient billing statements, so there is only one number to discuss.

What Diagnostic Imaging Integrated Patient Payments Software Handles

Self-pay payments against a good faith estimate

Uninsured and self-pay patients are owed a good faith estimate before scheduled care. A payment taken at booking is linked to that estimate, so the final bill, the payment and the estimate can be compared later. (CMS: Good faith estimates for uninsured or self-pay patients (No Surprises Act))

No check-in collection for Medicare screening mammograms

Medicare charges no Part B deductible or coinsurance for screening mammography. Check-in collection is turned off for those visits, and only a same-day diagnostic study billed with modifier GG can create a patient share. (CMS Medicare Claims Processing Manual, Chapter 18: Preventive and Screening Services (mammography codes and modifier GG))

Low-dose CT lung screening

Lung cancer screening with low-dose CT has no Part B deductible or coinsurance when the coverage rules are met. Staff do not collect at check-in for the screening, and any later diagnostic CT is collected after its claim pays. (CMS National Coverage Determination 210.14: Lung Cancer Screening with Low Dose Computed Tomography)

PCI DSS card security

Cards are stored as tokens by a payment gateway that meets the PCI Data Security Standard. Staff see only the last digits, and the full card number never sits in the imaging record. (PCI Security Standards Council: PCI Data Security Standard)

Collecting only the in-network share on protected reads

When an out-of-network radiologist reads at an in-network hospital or other covered facility, radiology is an ancillary service under 45 CFR 149.420. Payments for those reads are limited to the in-network cost share. (45 CFR 149.420: Notice and consent rules, including ancillary services such as radiology)

How Does Diagnostic Imaging Integrated Patient Payments Software Work?

1. 1. Price and collect self-pay studies at booking

   Staff give the cash price or estimate and take payment or a deposit when the study is booked. The payment is tied to the estimate on the account.

2. 2. Store the card with consent

   Patients who agree have a card stored as a token, with a note on what it may be used for. They can remove it at any time.

3. 3. Charge after the claim pays

   Once the payer has paid, the final share is charged to the stored card, or a text-to-pay link goes out with the amount. A receipt follows each charge.

4. 4. Set up plans for large balances

   Large MRI, CT or PET balances can move to a plan with a set amount and draft date. A failed draft creates a task for staff instead of a silent miss.

5. 5. Post and settle credits

   Each payment posts to the study and account as it clears. If a deposit was more than the patient owed, the credit balance is refunded under the practice's policy.

Diagnostic Imaging Integrated Patient Payments Software vs. Generic Software

Who Uses It in a Diagnostic Imaging Practice

• Scheduler: A clear cash price and a way to take payment at booking, so self-pay patients book with confidence.
• Front desk: Collection prompts that skip no-cost screening studies, so Medicare screening patients are not charged at check-in.
• Billing manager: Payments that post themselves to the right study, plans that run without chasing, and fewer refunds from deposits that were set too high.