RadNet Management Inc - Scalability, Reporting, and Patient Payment Portals for Radiology Billing


Back in May, ImagineSoftware held our 2018 Client Conference in Charlotte, NC. Every year, our customers graciously travel from across the country for three days of education, collaboration, and fun with the team. It's a great opportunity for us to see our clients face-to-face and to learn what challenges led them to selecting Imagine as their medical billing software provider. That insight helps us grow as a company to better serve both our current and future clients.

Medical billing is hard, that's where we come in.
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I had the opportunity to meet Cliff Bazhaw from RadNet Management, Inc, who helped me realize that the success of a medical billing software company and its customers relies heavily on the ability to offer and utilize a full range of solutions that make the lives of both clients AND patients easier. 

Cliff Bazhaw is the Vice President of Reimbursement Operations for RadNet Management Inc, the largest provider of freestanding, fixed-site outpatient diagnostic imaging in the country and an ImagineSoftware client of 3 years. 


Scalable Medical Billing

RadNet Management Inc is an imaging powerhouse in the radiology community, owning and operating over 300 imaging centers nationwide. "RadNet is several aquisitions combined into one company," said Cliff. "Our challenge from the beginning was that every aquisition used different billing software. We've been able to put all of our imaging centers onto one platform, so [ImagineSoftware] has certainly helped us from that perspective." 


Real-Time Reporting and Analytics

Another challenge that came along with managing so many locations was RadNet's ability to access reports in a timely manner. "We needed software that could give us unlimited reporting capabilities," said Cliff. "Software we've used before didn't have real-time reporting. To manage our imaging centers and A/R the way we wanted to, we knew we needed it real-time." ImagineSoftware's business intelligence tool played an important role in RadNet's selection of a new software provider. Cliff explained, "It's incredible. The information you get from the tool is all you really need to manage your A/R, and you get it in real-time. That's a big plus for us."




Improved Patient Collection Cycle

Cliff also spoke about the convenience of offering a payment portal for patients to easily pay their medical bills. As we've mentioned on the blog before, offering patient-centered solutions is where the industry is going. It recognizes a huge paint point that providers face in in terms of patient financial responsibility, which is at an all-time high. "I manage about 170 call center individuals who answer questions about patient statements," said Cliff. "[ImaginePay] helps us get patients on and off the phone quickly and it's really convenient for the end-user to obtain credit card information or ACH for checking. [The payment] hits the patient's account immediately, so from a billing cycle perspective, it's convenient for the patient and we don't have to send out more statements." 

To find out more about RadNet Management Inc and their experience with ImagineSoftware, watch the videos above and be sure to check out our radiology solutions page!

Medical billing is hard, that's where we come in.
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Patient Payment Solutions Form Thank-You Page

Thank you for contacting us!

We are excited to show you how our patient payment solutions help organizations just like yours to collect more of what's due from patients while improving the patient experience. A representative will respond to your inquiry as soon as possible. In the meantime, if you have any questions, please feel free to reach out to us!

Best Regards,

Elizabeth Suppa
Chief Marketing Officer
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8 Medical Billing Key Performance Indicators You Should Be Tracking in 2018

Today's billing landscape is not an easy one to navigate for many medical practices. The transition to value-based care and rising patient responsibility make the management of day-to-day operations even more challenging. Now more than ever, it's critical to regularly measure the financial health of your practice and if your staff is performing at peak efficiency. Key Performance Indicators (KPIs) help physicians and management understand the strengths and weaknesses of their revenue cycle and help guide future decisions. They also help prioritize resources and help recognize key success drivers. 

If you're feeling overwhelmed, start with a focus on quality and track KPIs that will heavily impact your financial performance. Here are eight you should track on a daily, weekly, or monthly basis and the tools you'll need to turn those numbers into actionable insights. 

Better financial performance begins with taking control of your data.
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Daily and Weekly KPIs

Cash Receipts - Revenue is the driving force of your business, so money that's collected and deposited should be monitored daily. Cash can't be benchmarked, but you can compare it to a previous period to ensure that cash flow is steady or improving. Keep in mind that this KPI can fluctuate greatly depending on things like the addition of new employees, new services, cancelled appointments and procedures, and how quickly patients pay for their medical bills. 

Charges - This KPI should be watched in conjunction with cash receipts. Since charges drive revenue, any fluctuation in charges will cause a fluctuation in cash, so monitor this closely. 


Payables - Knowing when your unpaid invoices are due and if your practice has the cash to cover them in a timely manner is absolutely critical. The more you can track and improve your payables, the more lenient your vendor credit terms may be, which can save your practice a lot of money. Also, you can increase accounts payable process transparency and accountability among A/P staff. 

Monthly KPIs

Days in Receivables Outstanding (DRO) - This is the average number of days it takes you to collect payments due to your practice. The calculation for DRO is:

DRO

You can certainly determine the average daily charge based on 365 days, but 90 days takes seasonality into account, as well as various fluctuations in business growth. So, how do you know if you're doing well? Here are the industry benchmarks for medical billing DRO:

High Performing Billing Department - 30 days or less
Average Performing Billing Department - 40-50 days 
Below Average Performing Billing Department - 60 days or more 

If your practice is hitting the below average mark or even the average performing, there are a lot of things you can do to improve your number. Analyze your back-end processes to ensure that you're avoiding duplicate billing, incorrect CPT modifiers, and inaccurate patient information that lead to more claim denials. Consider your patient payment process as well. Are you making it convenient for patients to pay their bills? Tools like an online patient payment portal and payment plans give patients the ability to pay for their medical expenses in a way that works for their budget. And bonus, they improve patient retention too! 

Receivables Outstanding Over 120 Days - This is a great indicator of whether or not your patients and insurers are paying you in a timely manner. This KPI will also pinpoint claim denial timeliness issues and effectiveness of follow up on no-response claims. The calculation is:

Receivables outstanding over 120

A realistic number to shoot for is less than 12%. You can obvisouly change the age category to whatever you choose, but the point it to choose a category and stick to it for consistency. You can track this KPI in two ways:

By Patient - Patients are the new payers in healthcare, so it's obviously critical to keep track of this number. This calculation can be affected by eligibility verification, how patients are paying for their bills, and whether or not they have a clear understanding of how their insurance works. Like DRO, you can improve this number by analyzing and improving your patient payment process. 
By Insurer - This ratio will indicate whether or not your in-house billing staff or outsourced staff is tracking reimbursement and denials effectively. 

Denial Rate - This KPI tracks the percentage of denied claims and provides insight into how efficiently your claims process is operating. You can calculate your denial rate with the following:

denial rate

To improve this number, consider how much your claims management process is manual. You can accelerate your collections performance with claims scrubbing, electronic remittance and auto coding/charge posting. You can learn more about that here

Resolve Rate - This is a great reflection of the overall effectiveness of your RCM process - from eligibility to coding and billing. The calculation for resolve rate is:

resolve rate

The higher the percentage, the better. If your rate is high, that means your staff and the proceses they follow are working effectively. If your rate is low, look at eligibility verification, coding, authorizations, and credentialing. Since providers spend 10-30 minutes and $50 on average to re-work a claim, a low rate impacts both cash flow and staffing costs. 

Cash Collection as a Percentage of Net Patient Services Revenue - This KPI evaluates your ability to transfer net patient services into cash. You can develop this KPI with this calculation:

cash collection as percent of net patient services rev

When making this calculation, be sure to exclude a few things: patient-related settlements and payments, Medicare pass-through, and Medicaid DSH payments. You should also avoid collected patient service cash from ambulance services, post-acute services, and physician practices and clinics unless they're recognized as a provider-based clinic by Medicare. 

We've mentioned the tools you need to improve these KPIs, but what about the tools you need to analyze them in the first place? They key is organizing your KPIs into dashboards through a business intelligence reporting and analytics tool. This will improve your ability to identify trends and patterns, as well as increase awareness around what variables impact your practice. It will also allow you to easily share those findings with staff and management! 

Receiving these reports on a daily, weekly, and monthly basis will improve your ability to monitor financial performance by leaps and bounds. But keep this in mind, these are only outcomes and a report won't improve them for you. Analyze your reports, ask questions, work closely with your billing department, and help steer them in the right direction to improve KPIs and the practice as a whole. 

Monitor, analyze, and improve your financial health from one dashboard.
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Claims Management Solutions Form Thank-You Page

Thank you for contacting us!

We are excited to show you how our claims management solutions help organizations just like yours to realize more revenue without an increase in workload. A representative will respond to your inquiry as soon as possible. In the meantime, if you have any questions, please feel free to reach out to us!

Best Regards,

Elizabeth Suppa
Chief Marketing Officer
This email address is being protected from spambots. You need JavaScript enabled to view it.

Solutions - Patient Payments

An all in one solution for patient and staff convenience

patient payment solutions

Why don’t patients pay their medical bills?
Many don’t understand their insurance plan and a larger portion simply can’t afford to pay, until now. Arm your collections workflow with an automated software solution that eliminates payment confusion, gives patients an affordable way to pay their medical bills, and automates time-of-service and statement payments.

Solutions - Claims Management

More revenue without the manual workload

Claims Management Solutions
Accelerate your collections performance with tools that are designed to help you save staff time and create streamlined claims management, correcting errors that create denied claims like duplicate billing, incorrect CPT modifiers, and inaccurate patient information.

HBMA 2018 Healthcare Revenue Cycle Conference

Meet with ImagineSoftware at the HBMA Revenue Cycle Conference

HBMA 2018 Healthcare Revenue Cycle Conference

September 12-14, 2018
Sheraton Hotel
Charlotte, NC

Booth # 406
Wednesday, September 12th – 6:00pm to 7:30pm
Thursday, September 13th – 9:30am to 10:30am | 12:45pm to 1:45pm | 6:00pm to 8:00pm


Schedule Your Meeting with the Imagine Team

NAFEC 2018

Meet with ImagineSoftware at NAFEC

NAFEC 2018 – 4th Annual National Freestanding Emergency Center Conference

September 10-12, 2018
Omni Mandalay Hotel
Dallas, TX

Monday, September 10th – 5:00pm to 7:00pm
Tuesday, September 11th – 10:00am to 5:00pm
Wednesday, September 12th – 10:00am to 4:00pm


Schedule Your Meeting with the Imagine Team

3 Reasons You Should Offer Patient Payment Plans

The transition from volume-based to value-based care will have a monumental impact on what it means to be competitive in healthcare. There’s a growing interest in the convenience of digital communication, patient payment plans, and more options for paying healthcare bills online with an increasing financial responsibility falling on patients' shoulders.
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11 Things to Know About ICD-11

The countdown begins! The World Health Organization (WHO) recently announced the expected release of the International Classification of Diseases, Eleventh Edition (ICD-11), and some of the major changes that will follow. The World Health Assembly meets to accept the proposed version in May 2019, and the WHO effective date for ICD-11 is January 1, 2022. You may be thinking, "Jenna, why are you telling us about this when we don't have to worry about it for another 4 years?" There's a reason the WHO made this announcement so far in advance. You have more time to prepare for implementation, and for some providers, this version will be a huge undertaking. Here are 11 things you should know about ICD-11. 

Medical billing is hard, that's where we come in
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  1. There are 30 chapters in ICD-11, compared to 21 in ICD-10. Areas of interest include the addition of Gaming Disorder to the Addictive Disorders section and Gender Incongruence moved to a new Sexual Health chapter.
  2. Some of the new chapters include the following:
    1. Diseases of the Immune System
    2. Sleep-Wake Disorders
    3. Conditions Related to Sexual Health
    4. Developmental Abnormalities (separated from Conditions Arising in the Perinatal Period)
    5. Codes for Special Purposes
    6. Traditional Medicine Conditions
    7. Supplementary Section for Functioning Assessment
    8. Extension Codes
  3. Gaming Disorder will be newly added to the Addictive Disorders section. Gaming Disorder is described as a "pattern of persistent or recurrent gaming behavior ('digital gaming' or 'video-gaming') which may be online (i.e., over the internet) or offline, manifested by impaired control over gaming, increased priority given to gaming to the extent that gaming takes precendence over other life interested and daily activities, and continuation or escalation of gaming despite the occurence of negative consequences. This will be done in efforts to raise awareness among medical professionals and to help provide prevention and treatment. 
  4. ICD-11 will better capture data regarding healthcare safety. "With ICD-11, patient safety events can be recorded better than ever before and prevented," said WHO's Classifications, Terminologies, and Standards Team Lead Robert Jakob, MD. "This is a topic of extreme relevance that has not been possible to document properly with the old ICD. With the new ICD-11, we have a complete system to document events or near misses."
  5. Codes will have four (instead of three) characters before the decimal point and up to three characters after. This will be done to provide further specificity in the associated condition or injury. 
  6. Codes will range from 1A00.00 to ZZ9Z.ZZ and all three of the code set volumes - Index, Reference and Tabular - are required to correctly assign the code.
  7. Terminal letters. Terminal letter "Y" represents the "other specified" category, and the terminal letter "Z" is reserved for the "unspecified" category. 
  8. "Code also" instructions will provide additional information that should be coded in conjunction with certain categories because the information is relevant for primary tabulation. "Due to" will refer to the linkage of two conditions with causal relationship. "Associated with" will refer to the linkage of two concurrent conditions without causal sequence.
  9. Categories will have a short description and long definition labeled 'additional information'. The short description will consist of a 100-word maximum, while the long 'additional information' will contain the full definition, without length restriction. 
  10. The goal is for ICD-11 to function in an electronic environment and support electronic health records (EHRs). This version will link with the Systematized Nomenclature of Medicine (SNOMED-CT), which is already a component of many EHRs. 
  11. Sections on Cardiology, Allergies and Immune System Disorders, Infectious Diseases, Cancer, Dementia, and Diabetes will be extensively updated. This is being done in efforts to promote proper documentation, support research, and produce new methods of treatment. 
Want more information on ICD-11? The WHO's website contains descriptions of the ICD-11 code development process, a code browser, and a timeline for the ICD-11 introduction. 

 
For better billing productivity and profitability.
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Sources:

http://www.who.int/classifications/icd/revision/en/
https://www.icd10monitor.com/icd-11-hurry-up-and-wait
https://www.beckersasc.com/asc-coding-billing-and-collections/icd-11-contains-nearly-4x-as-many-codes-as-icd-10-here-s-what-who-has-to-say.html
https://www.beckersasc.com/asc-coding-billing-and-collections/icd-11-will-include-9-new-chapters-and-several-changes-8-key-updates-to-note.html

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