Healthcare Information Systems Solutions since 1980 JULY 21, 2011 / Issue 28
Featured Article
No denying it – outsourcing billing has its advantages

By T. Scott Law, president and CEO of Zotec Partners

Shifting from in-house billing to outsourcing significantly reduces denials and cost of collections for Atlantic Medical Imaging.

Atlantic Medical Imaging (AMI) is a full-service outpatient imaging practice operating eight offices throughout New Jersey and providing professional services to three area hospitals. With 38 board-certified radiologists and a staff of 350 technical, clerical and administrative personnel, AMI has been committed to providing the most advanced diagnostic imaging services to patients and referring physicians for more than 40 years.

But no business can run smoothly and successfully without closely monitoring its revenues and costs, and this is especially true of medical practices. That’s where Zotec Partners comes in.

In May 2009, AMI licensed our Electronic Billing Center (EBC) software in an effort to keep billing in-house, reduce costs and capitalize on the potential for revenue. In less than a year, the group realized that collections performance was not being maximized by its internal billing staff of 25 employees.

As a result, in May 2010, AMI turned billing completely over to our company, ensuring that the group can now focus on its clinical care and not worry about the bottom line. Capturing, auditing and processing every procedure to maximize income are now our responsibility.

The challenge: missing industry benchmarks; performance problems

A dizzying array of consumer-driven health insurance plans, including health savings accounts (HSAs), can bury any practice under an avalanche of medical billing paperwork.

Obtaining every collectible dollar at a lower cost of billing is the goal – not an easy task for practices like AMI that read more than 500,000 exams each year.

“Prior to outsourcing our billing, the standard metrics used in the revenue cycle industry were falling well below industry benchmarks,” says Dr. Robert M. Glassberg, president and CEO of Atlantic Medical Imaging. “Our key performance indicators showed the need for improvements in our accounts receivables management.”

This issue was magnified by AMI’s own performance issues.

“When doing our own billing, we faced some performance problems,” says Glassberg. “Then, as we compared rebuilding our internal billing operations against outsourcing them altogether, the latter option with Zotec Partners was our best choice.”

Any missed bill translates into AMI’s physicians working for free. While the EBC software contains radiology-specific coding to ensure accuracy and optimum payment for the work that is completed, our Radiology Information System (RIS) allows the most efficient process flow for the practice.

“We use the RIS for scheduling and registration 100 percent of the time,” says Glassberg. “It has become an integral part of our workflow.”

The RIS is resource based and template driven, allowing it to effectively manage AMI’s practice scheduling and workflow needs. Features available with just a few clicks of a mouse include the ability to overbook, block and reschedule appointments.

Other benefits include the ability for AMI to create unlimited resource templates, collect patient co-pays, update demographics and scan patient information. And because the software is integrated with the EBC, users receive notifications regarding the status of a patient’s account before scheduling exams.

Our Decision Support software has been another key tool for AMI. The reporting technology allows the group to drill down into its business information for data mining and analysis purposes – giving it a rock-solid platform and scientific approach in making critical business decisions.

“The Decision Support module has allowed us to make more data-driven decisions, whereby previously we made more gut-driven decisions,” says Glassberg.

The results: Cost savings, fewer denials

The result of outsourcing billing has been lower overhead and increased payments for AMI – a prescription for financial success for any practice.

AMI’s billing staff has been reduced from about 25 individuals, or an entire department, to one full-time billing employee and less than five additional employees overseeing the process.

Most importantly, denials are down to the single digits on a monthly basis.

But the biggest advantage with outsourcing its billing has come in cost savings at the practice, allowing AMI to focus on one of its core values: clinical excellence.

“There’s little doubt in my mind that we are spending less to collect payment than what we previously were. Our percentage of revenue assigned to billing has gone down significantly,” says Glassberg. “Performance is certainly an improvement from the internal problems we were having, which drove us to make a change in the first place. We have realized a big savings on the cost side, and that’s very important for any group in this era of declining reimbursement.”

About the author

T. Scott Law is the founder and CEO of Zotec Partners. For more information on Zotec Partners solutions: http://www.zotecpartners.com.

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