Maintaining the Health of Your Radiology Information System (RIS)

A healthy RIS is a critical component of a healthcare facility. Make sure that yours is working the way it should to avoid lost reimbursement and reduce the risk of compliance issues.

The radiology department is typically one of the biggest within a healthcare facility, and the Radiology Information System (RIS) is a critical component of this department. Facilities rely on these systems to manage imaging protocols by modality as well as charging for services and orderables. Therefore, if your RIS contains incorrect or outdated data, you can quickly run into patient care, reimbursement or compliance issues.

Many facilities do not have the resources to dedicate a full-time employee to keep the RIS up to date. The task is often delegated to managers who are already working full-time managing their team or even IT staff who may not have the background or expertise necessary to correctly determine which codes should be linked to which procedures. At Panacea, we have seen both of these situations in our work with clients.

So, what is a facility to do? At the very least, you need to make a comprehensive, end-to-end review of your RIS an annual occurrence. To help you get started, we’ve pulled together the reasons why an annual review is so important, what you should consider in a review and what your end goals should be.

Why Conduct an Annual RIS Review?

Your RIS is far from static. Between the potential for quarterly code updates as well as annual updates and adjustments such as new services or procedures, frequent changes are inevitable. Checking your RIS each year provides the opportunity to make sure all of these adjustments have been made properly and are working together as they should be. It also ensures that you catch any mistakes within the year so that you can make any claim corrections if needed.

This need for yearly review is demonstrated well by a situation our experts encountered where the RIS was incorrectly set up to only drop one code for any bilateral tests or procedures. In other words, it was a two-for-one special anytime the facility did a bilateral test or procedure. They weren’t doing annual RIS reviews, so they didn’t notice this mistake for over 3 years, and it likely cost them millions of dollars in reimbursement.

The moral of this story? Make sure you are conducting a thorough RIS review at least once a year.

What Your RIS Review Should Consider

When you’re conducting a review, it’s important to go into it knowing what to look for. So, when you dive into your annual RIS review, what areas do you need to consider? Below are some key points to help structure your approach.

  • Understand who is affected.

    You need to consider the doctors, the technologies, and the coding and billing staff. Are they provided the correct information required to do their job well?

  • Ensure any updates are implemented correctly.

    As previously noted, your RIS should receive frequent updates, and it’s important to ensure that they are all set up correctly. Have all affected modalities and orderables been updated as well?

  • Check your descriptors.

    The descriptors within your RIS are what your technologists are relying on to select the correct exam. Don’t assume that because something has always been shortened to a specific phrase that it will be clear—you want everyone, from the 20-year veteran to the brand-new tech, to clearly understand what they are selecting.

  • Double-check reoccurring issues.

    Check in with your coders to see if there are specific problems hitting their work queue that they see over and over again. Any repeat offenders may be an issue within the RIS setup itself. This means that you could have claims making it through the scrubber with the same issue, setting you up for compliance issues.

The End Goal

Of course, the end goal of any RIS review is identifying and correcting issues to ensure you’re not creating any reimbursement or compliance problems. Here are several guiding principles to keep in mind as you pursue the goal of maintaining a healthy RIS:

  • Ensure your technologists know how your system works and what their protocols are.

    This means that your descriptors need to be clear so that technologists understand what procedures to select and are not selecting multiple services because they don’t realize one service is a component and therefore covered under another procedure they’ve already selected.

  • Ensure the codes and descriptors are linked correctly.

    This helps you avoid incorrect billing—either over- or under-coding—and minimizes your compliance risk.

  • Ensure your coders understand how the RIS works.

    If they understand how services are set up within the RIS, then they will understand when they need to escalate an issue so that it can be corrected within the RIS, instead of correcting it in the claim they’re working on and moving on to the next one.