Radiology Case Study
Radiology Case Study
Radiology Case Study
Case Study: Radiology Revenue Recovery: $800K Reclaimed by Fixing the Fundamentals
Executive Summary
Precision Imaging Group, a well-established 20-radiologist practice operating across three busy outpatient centers, had a quiet problem on its hands. Despite strong referrals and high-quality imaging, their revenue cycle wasn’t keeping up. Denials were rising, prior authorizations were slipping through the cracks, and cash flow felt tighter each quarter. It wasn’t one dramatic failure. It was a steady leak, and nobody could quite trace where it was coming from.
What they needed wasn’t a new software or a templated billing service. They needed someone to sit down, roll up their sleeves, and fix what was broken at the source. That’s where Scionis RCM came in. In six months, the financial picture changed. Collections went up by over $800,000 annually. Denials dropped by 70%. Days in A/R fell. And for the first time in years, the billing team wasn’t overwhelmed.
Where Things Were Slipping
Precision Imaging had all the ingredients for success clinically. But under the surface, the billing side was showing signs of strain:
- Modifiers Were Getting Them Denied: Exams like MRIs and CTs were regularly kicked back over technical vs. professional modifier issues (26/TC).
- Authorization Delays: Prior auths for advanced imaging were either late or missing entirely. That meant delays for patients, and in too many cases, no payment at all.
- Radiologist Reports Missed the Mark: Dictations often lacked the specific language payers needed, like whether contrast was used or why a repeat scan was necessary.
- Interventional Procedures Were Undercoded: These were high-value services, but missing details in reports meant they weren’t billed fully.
- Denials Were Ignored: The billing team was small and constantly behind. Appeals weren’t getting done, and when they were, they lacked strategy.
Compliance Was Becoming a Worry: Leadership knew the risk was growing. Payer rules were shifting fast, and they didn’t have the capacity to keep up.
Scionis RCM’s Hands-On Fix
This wasn’t a job for flashy software. It was about getting the right people in the right seats, seeing the actual problems, and correcting them one by one.
1. Specialty Coders Who Know Radiology
We didn’t assign generalist coders. We put in credentialed, experienced radiology coders who knew the difference between a clean claim and one that was going to get rejected. They caught modifier mistakes before the claims left the building. They scrubbed reports for clarity. They ran regular audits and fed that information back to the radiologists to tighten up their notes.
2. Prior Authorizations Were No Longer a Gamble
We took over that entire workflow. Every patient was verified in real time. Our team followed up with payers, not once, but as often as it took. Imaging wasn’t delayed, and when scans were done, payment followed.
3. We Didn’t Just Resubmit Denials, We Solved Them
Every denial was logged, studied, and categorized. If it was a documentation problem, we spoke with the radiologist. If it was payer-driven, we challenged it with the right arguments. Appeals weren’t generic, they were written with data and precision.
4. We Worked With the Radiologists, Not Around Them
This wasn’t just back-office cleanup. We trained the clinical team on how specific phrasing impacted reimbursement. We helped them revise report templates so payers got the answers they were looking for the first time around.
5. Real Numbers, Real-Time
We gave the leadership team clear dashboards with the metrics that mattered: denial reasons, aging A/R, collection trends. They didn’t need to guess where things stood anymore. They had visibility, and they used it to steer the ship.
What Changed in Six Months
- Denials Dropped 70%
- Collections Increased by Over $800,000 Annually
- A/R Days Fell from 60+ to 30-35 Days
- Prior Authorization Success Rose to 98%
- Recovered $50,000 in Missed Underpayments
More importantly, the billing team got breathing room. Leadership got answers. And the radiologists could finally stop worrying about revenue every time they opened a new case.
Lessons from the Field
- Radiology Requires Dedicated Coders: This is a specialty. You can’t fake your way through it with general medical billing.
- Fix It Before You Bill It: The fastest way to reduce denials is to stop sending out broken claims.
- Doctors Need Feedback: Don’t assume they know what payers need. Show them.
- Denial Data Is Worth Studying: It’s not just rejections. It’s a roadmap to fix what’s broken.
Human Expertise Still Beats Software Alone: Technology helps, but experienced hands are what really move the needle.
If It Feels Like You’re Leaking Money, You Probably Are
Radiology practices don’t need gimmicks. They need partners who know what they’re doing, and who aren’t afraid to get into the weeds. Scionis RCM didn’t just improve Precision Imaging Group’s numbers. We gave them a revenue cycle they could count on.
If you’re tired of guessing where the money goes, let’s have a real conversation. We’ll find the leaks. We’ll fix them. And you’ll finally get paid for the work you already do.
Want to work with us?
Partner with Us to Drive Excellence
in streamlining complex revenue processes, recovering lost revenue, and optimizing cash flow.
With our expertise, you can focus on delivering exceptional patient care while we enhance your
financial efficiency and growth.