After Branching into Remote On-Demand Radiology Consulting and Business Services, St. Paul Radiology Turns to Revenue Cycle and IT Specialists to Meet Demand All radiology practices specialize in the art of seeing—but St. Paul Radiology (SPR) has demonstrated that its vision extends far beyond x-rays and CT scans. The large radiology practice was the first of its kind in St. Paul, Minnesota 85 years ago; it was also a regional leader in adopting the most advanced equipment, techniques and services. SPR’s most far-sighted move, however came with its debut of Emergency Radiology Services, LLC (ERS). The new subsidiary serves hospitals and radiology practices around the country, delivering remote, on-demand teleradiology consultations on a 24/7 basis along with a full range of business support services including practice management, accounting/finance and billing. The opening of ERS turned what was already a large practice—St. Paul Radiology has seven standalone imaging centers serving hundreds of thousands of patients—into an enterprise with clients in all 50 states. Forty SPR billing specialists, in fact, now process claims from over 350,000 new patients every year. “Once ERS caught on, our business exploded,” said Karla Krey, Billing IT Supervisor for St. Paul Radiology. “We started looking for ways to improve the efficiency of our clearinghouse services which, at the time, couldn’t handle the growing workload.” Krey noted that remittances were a particular problem. Some individual Medicaid remittances were as long as 500 pages and each had to be posted manually. SPR needed a more sophisticated, comprehensive revenue cycle management partner that could speed such labor-intensive processes while also reducing the inevitable errors that found their way into submitted claims. At an industry conference, the St. Paul Radiology billing team asked for clearinghouse recommendations during a luncheon for attendees. “Several people told us that they used ZirMed,” Krey remarked. “That got us to take a look.” ZirMed, a Web-based revenue cycle management software provider, covers the entire payment process from eligibility to claims management, check processing and cash management. It also offers a spectrum of reporting and analytical tools that help billing managers optimize claims payment. “ZirMed’s ERA [Electronic Remittance Advice] capabilities were very attractive to us,” said Krey. “We knew that the ability to auto-post remittances from virtually any payer and post them automatically in the system would save us hundreds of man-hours every month.” Within months of working with ZirMed’s software as a service solutions, the SPR billing staff experienced not only a decrease in remittance work, but also a reduction in rejected claims caused by submission errors. “ZirMed helped us increase out productivity tremendously,” said Krey. “With our new auto-posting capability we were able to take a several-day process and complete it in just a couple of hours.” St. Paul Radiology’s billing efficiency took a further step forward when it signed on with healthcare IT support company Harmony Healthcare IT. “Harmony has given us a number of ideas to improve our billing workflow. They also helped us quickly resolve some hardware issues we had onsite,” Krey stated. “Their customer service, whether on the phone or in person, is exceptional.” The combination of ZirMed and Harmony has helped St. Paul Radiology maintain, or even increase, its efficiency levels at every point along its dramatic growth curve. Initial studies showed the introduction of ZirMed resulted in a 35-40% decrease in Accounts Receivable days—an improvement that Krey credits to ZirMed’s claims management solution and robust edits. “ZirMed is our ‘holding tank’ for claim scrubbing before claims are submitted,” she pointed out. “It makes a huge difference in how quickly we can get paid. With just one payer alone, our remittance cycle dropped from a month to two weeks.” While claims management and auto-posting are the two biggest pieces for St. Paul Radiology, it has added other services from the ZirMed solution suite. By replacing three other vendors for credit card payments with ZirMed’s “Z-Pay” Web-based credit and debit card solution for patient payment, it has simplified its paperwork, reduced the number of dedicated phone lines, and allowed card payments to be made from any PC. Krey also points to ZirMed’s Physician’s Quality Reporting Initiative (PQRI) dashboard that allows physicians to track PQRI payments and deal with an otherwise extremely complex payment system. “We’re currently considering other ZirMed revenue cycle additions such as eligibility verification and printing and mailing services,” she noted. “I can’t say enough about the efficiencies ZirMed provides. It removes the tedious work and allows us to use our staff for more productive purposes.”