Radiology - Diagnostic Radiology

Specialty: Radiology – Diagnostic Radiology

Service Offering: AR and Credit Balance

Practice Management Software: Imagine

Introduction

Our team at Spinfluence Services Solutions specializes in streamlining revenue cycle processes to help healthcare organizations optimize their financial performance. This case study showcases how we partnered with a radiology imaging center to address their AR and credit balance challenges, significantly improving efficiency and financial outcomes.

Background

The radiology client is a multi-location imaging center serving thousands of patients monthly. Despite their high patient volume and steady revenue stream, they faced persistent challenges in managing accounts receivable (AR) and unresolved credit balances. These issues directly impacted cash flow and operational efficiency.

Revenue Cycle Challenges
  • Inefficient tracking and resolution of outstanding AR accounts.
  • High volume of unresolved credit balances leading to compliance risks.
  • Extended average payment cycles and reduced monthly revenue.
Objectives
  • Reduce the credit balance backlog by identifying and resolving accounts efficiently.
  • Accelerate average payment cycles by streamlining AR workflows.
  • Enhance monthly revenue and maintain compliance with payer guidelines.
Intervention

Our approach included the following steps:

  • Data Analysis: Conducted a comprehensive audit to identify key issues in AR and credit balance workflows.
  • Customized Strategies: Implemented tailored solutions, such as standardizing claim submission processes and focusing on denial trends.
  • Workflow Automation: Introduced automation for credit balance tracking and AR follow-ups to ensure timely resolutions.
  • Team Training: Equipped staff with training on payer-specific guidelines to increase efficiency in claim and denial management.
  • Regular Monitoring: Established a weekly review process to track performance metrics and adjust strategies as needed.
Results
Metric Before Implementation After Implementation Improvement (%)
Clean Claim Submission Rate 82% 95% 16%
Working on Denied Claims 35 Claims/Day 50 Claims/Day 43%
Denial Rate 12% 7% 42%
Average Payment Time 45 days 30 days 33%
Monthly Revenue $750,000 $900,000 20%
Conclusion

By addressing AR and credit balance issues, the radiology client achieved measurable improvements in operational efficiency and financial performance. Our systematic approach not only optimized their revenue cycle but also laid the foundation for sustained growth and compliance.
This case exemplifies our commitment to delivering tailored, results-driven solutions for healthcare organizations.