Resolving Backlogged 120+ Day Aged Accounts for Tennessee Radiology Network

The largest outpatient diagnostic imaging network in Tennessee operates 14 diagnostic imaging locations throughout the region, providing convenient patient access to over 50 board-certified, sub-specialized radiologists utilizing state-of-the-art diagnostic imaging technology, including PET/CT, MRI, CT, nuclear medicine, mammography, ultrasound, and X-rays.’

As the demand for the client’s radiology services continued to grow, their Accounts Receivable team struggled to keep pace. In particular, they sought a viable option to resolve a glut of 120+ day past-due accounts, which created several nagging problems:

  • 120+ day accounts represented 20% of their A/R backlog – $3.5M outstanding
  • 14% of these outstanding balances were insurance denials–from both public and commercial payors
  • Most of the accounts were nearing their deadlines for timely filing and appeals

Finding The Best Solution

Examining a range of options, they decided on choosing an external RCM partner around two key objectives:

  • Specific expertise and resources for high-volume A/R
  • A solid SLA with aggressive performance targets, audits and reporting

After selecting Infinx, we deployed a team of our top radiology A/R specialists, who were already adept at the client’s existing practice management system (PMS) platform. The following strategy was set for tackling the backlog of aged accounts:

  • Our team organized the client’s A/R backlog between insurance and denials, dividing each into two categories: 120-365 days past due and one year or longer
  • Primary emphasis was given to resolving the 120-to-365 day accounts which were approaching time limits for filing or appeals
  • 1+ year accounts were reviewed for remaining filing/appeal opportunities, or were reconciled in conjunction with the client’s in-house team
  • Infinx created separate queues for authorization and coding denials, assigning specialists to each for speedier resolution
  • Appeals were accelerated by an Infinx custom FTP link to client’s system, enabling local mailing of appeal paperwork locally in advance of filing deadlines

Infinx Makes The Difference

Following an initial trial, the client reviewed our performance, and were pleased with the overall results:

  • The GCR on claims aging 120+ days was increased by 12%
  • Inventory aged past 120 days were reduced by 47% – to only 11% of the total claims
  • Accounts were maintained at quality levels of 98%
  • Our team identified trends and root causes aecting preauthorization and other workflows. We developed and implemented process improvements for their in-house team to reduce denials and payment delays
  • The client also observed significant improvements in collection rates, dashboard reporting and other key metrics

Let’s Optimize Your RCM Workflow

Schedule a call with our team to learn how our solution can help optimize your revenue cycle.

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