No more billing and admin tasks helped this group grow to 20 times its size

No more billing and admin tasks helped this group grow to 20 times its size

Jessica Kania | Radiology Business Journal

This practice expanded from 3 to 60 radiologists in under 2 years, without private equity overlords. Here’s how.

In late 2020, KC Tan MD Medical Corporation was a three-physician radiology group in Arcadia, Calif., covering three hospitals. Today, the group is a 60-radiologist, multispecialty practice consisting of radiologists, neuroradiologists and neurointerventionalists covering 14 hospitals, and now has an additional location in La Quinta, Calif. How did the group grow so quickly and broadly? By handing off revenue cycle management, cybersecurity enforcement, and general support functions—and partnering with Collaborative Imaging for 24/7 advice.

KC Tan MD Medical Corporation’s three physicians had already been working with a billing company, but that company relied on a process that was almost entirely manual. There was no online portal for the physicians to view their revenue, no real-time reporting, no auditing, and—perhaps most importantly—no transparency.

Troubling too were the double-digit denial percentages the practice was encountering with health insurance companies often denying reports under a category of “does not meet medical necessity.” Kok Chye (K.C.) Tan, MD, the president of the group, and his team were doing the work, but frustratingly, were sometimes having trouble getting all of the coding details and other complex billing requirements exactly right in order to get paid in a timely fashion.

With ambitions to scale, Tan and his fellow physicians knew the practice needed to find a revenue cycle management partner that was doing a better job using technology.

Here’s why he turned to Collaborative Imaging to meet not only his billing and collections needs, but also for managing other back-end processes critical to streamlining its operations: recruiting, contracting, credentialing, cybersecurity, and worklists. The partnership helped fuel the practice’s exponential growth by allowing Tan to hand off just about every task other than the one he considers most important: reading images.

Beating billing battles

The first step for KC Tan’s partnership with Ci was to solve its billing problems once and for all. To do so, Ci’s AI solutions went to work combing through patients’ medical charts together with the practice’s radiology reports, for the purpose of ensuring that the radiologists performed all ordered exams, included all necessary information for coding and compliance, and satisfied any health insurance company-specific billing requirements. Any deficiencies or errors were flagged for correction in real time.

“It’s not easy to know little innuendos between what can or cannot be done, what kind of timely filings have to be made when, when to maybe slow down and when to maybe step up. I think those are very intricate decisions to be made in managing the revenue cycle.”

Kok Chye (K.C.) Tan, MD, President, KC Tan MD Medical Corporation

Now, Ci handles it all. Denials have dropped sharply, now accounting for well under 1% of all submissions, typically hovering around 0.2% or 0.3%. Other tangible metrics have greatly improved as well. Before Tan started working with Ci, the average time from date of service to date of billing was around 30 days, which was acceptable, but not ideal—especially given that the practice was so small at the time, and should have been straightforward to manage and turn around quickly. Ci was able to get that turnaround time down sharply, typically billing within three days. Revenue has soared, too, with payment per work RVU increasing from 30% to 40%.

Ci’s RCM expertise, their end-to-end online patient portal, the opportunity to send text reminders, and the ability to file claims at all hours of the day came together were a contributing factor to the group’s success in growing, even during a pandemic.  

“Ci’s team are very good partners,” he says, “and they helped us by allowing us to focus on our core business—which is to take care of patients—and then they would optimize our back end functions.”

Finding the right people — and getting them credentialed and paid

No longer having to worry about revenue cycle management, KC Tan MD Medical Corporation could go full steam ahead on recruiting new physicians and expanding its practice. Here, too, Ci stepped up—first, by helping Tan find the best and brightest physicians to join his team. Through social media postings on various websites and different consortiums, they were able to connect the practice to the right people, which was a huge help given the current shortage of radiologists.

Additionally, Ci helped with negotiating and structuring physician employment contracts on KC Tan’s behalf. Their systems can handle a wide variety of payment structures, which helps attract radiologists with different payment preferences. For example, the group pays some radiologists a set flat fee, some per RVU, and some according to other metrics that both parties agree upon. 

Once new radiologists are onboarded, Ci also does the legwork to get them credentialed to the proper states and facilities and added to payer contracts with health insurance companies, all while negotiating with payers to get the best rates for their work.

Seeking cybersecurity

As the practice grew, so did their IT infrastructure needs—but figuring out compliance infrastructure or cybersecurity requirements can be complicated. So Ci stepped in to provide those services as part of their billing solution package. That’s especially important in California, where hospitals have to meet strict cybersecurity requirements when it comes to sharing patient data.

Expertise, a phone call away

In addition to the expertise offered in so many different areas of the radiology billing and administrative arena, Ci also fills an unofficial role as a sort of advisor-slash-consultant for all of the practice’s miscellaneous questions or concerns, including everything from advice on structuring payment practices to answering legal questions.

“They’re always willing to listen and work with you,” Tan says. “Every single baby step that they took in conjunction with us to cooperate and listen to these multiple voices enabled us to build this partnership, and create the platform that we have today.”