Pueblo Radiology was struggling to collect the bills that were due, until they did this.

Jessica Kania | Radiology Business Journal

Pueblo Radiology was expanding their practice and their client list—but until seeking a partner to manage their billing and revenue cycle, they had trouble collecting the money they were due. Here’s how their partnership with Ci changed that, and is helping their finances thrive. 

Since 1957, Pueblo Radiology has offered top-quality diagnostic imaging along with unparalleled customer service for patients, physicians and hospital affiliates in Santa Barbara, Calif., and surrounding areas — and it’s paid off.

The independent radiology practice has grown consistently over the years, and currently employs 25 fellowship-trained physicians. In addition to a busy outpatient imaging center in Santa Barbara, the group services six California hospitals, as well as three other outpatient facilities that are either hospital-affiliated or hospital-owned.

“It’s a very diverse practice,” says Jacob Harter, MD, the group’s medical director of the Santa Barbara office. “We have everything from musculoskeletal, body neuro imaging to a very active, sophisticated interventional radiology practice that does high-level work at a number of our hospitals.”

As Pueblo Radiology expanded its practice through regional growth and a growing list of affiliations, they were doing more work for more clients and more patients. But one very important question remained: were they actually getting paid for all of that work?

Finding a solution

The answer to that question was critical to the health of the practice’s business model—and Harter and others in the group had their doubts.

“We’re always concerned about being sure we’re collecting for all of the studies we’re reading and performing,” he says. “We weren’t sure that was the case. Our group is fiercely independent, and we want to succeed as a private practice. That means we’ve always got an eye out for better tools to help us be more efficient in ways we couldn’t accomplish ourselves.”

The status quo changed when a trusted radiologist colleague shared a new billing option they were using, and Pueblo Radiology group took a closer look. That solution came from Collaborative Imaging (Ci), a radiologist-owned alliance that shares best practices in clinical, operational and financial efficiencies via integrated IT and technology to help independent practices thrive. Ci works to equip partners with both the business acumen and technology needed to realize additional revenue opportunities while retaining their full autonomy as independent practices.

Radiologists at Pueblo Radiology involved in the decision-making process started reaching out to Ci clients to learn about their experience and benefits they were seeing in revenue gains, and the feedback was overwhelmingly positive.

“What I heard back was that all of the groups were happy,” Harter says. “They all said their collections went up, or their expenses went down, or a combination of the two. Financially, they were better off as a result of their affiliation with Ci.”

Due diligence behind them, Pueblo Radiology signed on to partner with Ci.

Quick results: better billing performance, lower turnaround time, clear information

To prepare for the transition, Ci representatives met with Pueblo Radiology staff, talked and walked through the process, and presented a billing transition plan from beginning to end.

“It was obvious that they were smart, they were good people,” he says. “The lines of communication were really open.”

Although the transition wasn’t simple—they were moving from one system to another system, and had to train staff—“it went pretty smoothly, to be honest,” Harter says.

By go-live in August 2021, Pueblo Radiology had officially made the move to billing for all services through Ci.

A year in, Harter says he’s already pleased with the results. “We’ve noticed an improvement in the billing performance, in the turnaround time metrics on the billing, the reporting metrics on the billing, and just the clarity of the information that’s available to us,” he says.

Objectively, they’ve seen an increase in the billing collections per RVU, which Harter cites as one of the most important and reliable metrics to understand their billing success. Additionally, he notes, the new setup means that the practice is now able to reconcile the cash coming in on a weekly basis, giving them a better handle on their collections as a whole.

“Prior to [starting with Ci] it was more of a monthly basis,” he says. “And so we had some delays in being able to u

Dr. Jacob Harter

nderstand and see what was going on with our billing collection activity. That’s been a substantial improvement in the overall process. And over the next six to 12 months, all we’ve done is going to be more visible and measurable.”

Laying the groundwork for something bigger: IT solutions and more

At the beginning of their partnership with Ci, billing was Pueblo Radiology’s most pressing concern by far—so that’s where they directed their initial focus. But all along, Harter knew that he also may be interested in exploring other Ci solutions, particularly on the technology side.

“If your systems are such that it allows you to focus on making the practice better, in ways that you never could accomplish before, that’s really appealing. Ci is committed to the success of radiology groups. That’s why they’re in it. They’re taking on things [for us] that they’re simply better at.”

“We’ve had problems with our PACS and RIS,” he says. “They are provided by the same vendor, so they were integrated, but did not work well and never did.”

Now that billing is on solid footing, Pueblo Radiology has already begun the process of moving additional services over, including IT solutions slated to bring the PACS and RIS to the level where they need to be. The group also has initiated the process of moving many administrative roles over to Ci.

“If we continue down the road that we’re on, they’ll be handling the IT side of our practice almost exclusively, a lot of the finance functions, HR support. We need to have a PACS in place that’s going to make our doctors more efficient, and a RIS that becomes a tool for patients and referring physicians to do business with us. We’re excited. It’s something we have high hopes for, and we believe it’s going to help the practice dramatically.”

Maintaining ‘fierce independence’

Although they have an eye toward moving more responsibilities to Ci in terms of the handling and optimizing of day-to-day operational matters, Harter notes that the practice still enjoys its independence, which is something that he’s always found absolutely non-negotiable. Over the years, he’s fielded—and rejected—numerous inquiries from potential buyers.

“We keep ownership, and it’s still the doctors’ practice,” he says.

Ci allows groups like Pueblo Radiology to maintain that independence, all while offering more efficient systems, cutting-edge technologies.

“If your systems are such that it allows you to focus on making the practice better, in ways that you never could accomplish before, that’s really appealing,” Harter says. “Ci is committed to the success of radiology groups. That’s why they’re in it. They’re taking on things [for us] that they’re simply better at.”