Radiology Imaging Associates Identifies $1.1 Million in Validated Underpayments
Summary
Radiology Imaging Associates (RIA), a radiology physician group, sought better solutions for handling payer underpayments. Their adoption of automated underpayment identification and contract management processes enabled them to identify $1.1 million in validated underpayments from just one payer.
The Situation: Group turns payment variance management over to biller
RIA employs 80 radiologists in 8 imaging centers across Florida. It is a provider group with advanced diagnostic imaging services that range from mammography to echocardiography and interventional radiology. RIA relies on its billing company for a variety of services, but found that underpayment identification and recovery was a growth lever they had yet to tackle.
The Challenge: Status quo processes allow revenue leakage
RIA struggled with a highly manual contract management process. They had turned payer underpayments over to their billing company but did not see tangible results.
The Solution: RevFind automates underpayments identification
After exploring contract management and underpayments solutions providers, they chose MD Clarity’s RevFind due to its proven ability to systematically identify payer underpayments and capacity to manage complex managed care agreements.
The Result: RevFind identifies $1.1 million in validated underpayments from just one payer
MD Clarity uncovered that the payer misinterpreted a nuance in their managed care agreement, causing widespread underpayments. MD Clarity identified $1.1 million in validated underpayments from just this one payer. RIA and MD Clarity continue to examine more payers to uncover underpayments.
“What I like best about MD Clarity is the personal contact and customer service I receive. They have given us a way to quickly identify underpayments by payers without having to rely on our billing company, providing us the extra insight we were missing before.”
— Revenue Cycle Manager, Radiology Imaging Associates
