Analyzing​ and ​Implementing RCM Ramp-Up for Local Radiology ​Group

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Infinx’s scalable RCM services mean no healthcare customer is too large—nor too small. One of our new customers is a smaller community radiology provider operating five locations within one medium-sized city in the U.S. Southwest. They offer patients a full spectrum of imaging technologies, from x-ray, MRI, ultrasound and CT scans to bone density screening and advanced mammography.

Difficulty ​Finding Qualified Administrative Staff To Handle Their RCM

While the customer has kept pace with providing their teams of board certified radiologists and technicians with state-of-the-art facilities and equipment, their Achilles heel has always been recruiting and retaining qualified administrative staff from among a limited local talent pool.

With experienced medical coding, preauthorization and billing skills at such a scarcity within the surrounding area, the customer endured a perpetual administrative backlog—often reflected in unfavorable patient feedback after vital imaging procedures were delayed or incorrectly denied by insurance payers.

After finally conceding an in-house office staff alone was no longer viable, senior management began searching for a stronger alternative. After evaluating options among several vendors, they eventually turned to Infinx to implement a custom-tailored end-to-end RCM solution.

Our Onboarding Strategy: ​Filling ​In ​The ​Skills ​Gaps

Our first step, as with all new customers, was an onsite visit to observe their existing processes firsthand. During our initial consultation, we identified four specific “pain points” which required advanced solutions:

  • Insurance eligibility/verification ​​was particularly hindered by the inconsistency of the
    local talent pool.
  • Preauthorizations lagged behind schedule—forcing rescheduled patient appointments or high-priority procedures to be performed without proper insurance authorization.
  • ICD-10 ​​coding bottlenecks were created when as much as 30 percent of medical records were delayed beyond 48 hours.
  • Payment ​posting by the in-house team endured a routine 10-15 day backlog.

We first worked with the customer to establish an agreed-upon Standard Operating Procedure (SOP), which outlined their preferred ‘dos-and-don’ts’ for transactions with specific payors, including Medicare claims.

After determining the required manpower resources, we assigned several radiology coding and billing specialists from our existing team, familiarizing them with the customer via online training sessions. Our ramp-up process concluded with initial productivity targets for the first 30 days, with goals increasing beyond the following 30-90 days.

An Added Wrinkle: Simultaneous PMS Migration

Our new partnership with this customer coincided with their planned transition to a new patient management software (PMS) system. Typically a rocky experience by itself, the challenges from this migration were further met by our specialists, who are adept at most standard PMS platforms.

Revenue Cycle Managed

Following our evaluations and initial project ramp-up, early results for this customer have been very positive:

Insurance verification and preauthorizations have dramatically increased, thanks to our cloud-based patient access solution, iBridge. Infinx is upscaling toward an eventual 100% of the customer’s preauthorizations.

  • Insurance verification and preauthorizations have dramatically increased, thanks to our cloud-based patient access solution, iBridge. Infinx is upscaling toward an eventual 100% of the customer’s reauthorizations.
  • Daily coding record turnarounds are dropping for the previous 20-30 percent toward our target of only 5 percent.
  • Infinx has assisted in tackling the customer’s PMS migration, eliminating the previous payment posting backlog.

The administrative issues which had plagued their operations have been largely alleviated, leading to satisfied patients and stronger relationships with referring providers.

Learn more about Infinx and our advanced RCM solutions for healthcare practices of all sizes.

InfinxAnalyzing​ and ​Implementing RCM Ramp-Up for Local Radiology ​Group

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