Insights Tips Independent Imaging Practice

Insights & Tips on Helping the Independent Imaging Practice Thrive in 2025 -Feb 2025

Brian Casey, Managing Editor, Imaging Wire - All right, everyone. Hello, and welcome to today's webinar Insights and Tips on Helping the Independent Imaging Practice Thrive in 2005, in partnership with RamSoft and Stockdale Radiology. My name is Brian Casey.

I am managing editor of The Imaging Wire. We got a great program for you. We're going to start with a panel discussion on some of the challenges facing imaging practices today and how new IT technology offers a solution. Then we'll open it up for questions in the second half of the webinar.

You can ask a question at any time using the Q&A button on the bottom of your screen. Our panelists are Lorenzo Michaels, a revenue cycle and practice management expert at Stockdale.

Also, Breda Drury is a senior clinical product marketing manager at RamSoft, a leading provider of cloud-based risk pack solutions. And then finally, Erinn Suadi, co-founder, practice manager of Stockdale Radiology, an independent imaging practice with four centers in California.

It's no secret that independent imaging practices are under a lot of pressure these days, ranging from staffing to equipment costs to reimbursement. Lorenzo, can you talk about some of the challenges that independent practices are facing right now and maybe how thing shave changed in the last 10 or 15 years?

Lorenzo Michaels, revenue cycle expert at Stockdale Radiology - Yeah, there's just been a perfect storm of decreased revenue from our reimbursement side, lack of skilled staff, especially since COVID for some reason. Just the overall demands of the complexity of the payer mix. So many HMOs were in California.

The managed plans are springing up by the day. You know, where do you go to get authorization for these things? Where do you go to check eligibility?

All these plans are just adding so much complexity and trying to manage an ongoing staff that are coming in and out. We're competing in California with minimum wage has gone to $25 an hour in the hospitals. And while the smaller imaging centers have largely been exempt from that, some of the other places like Urgent Cares are not.

We are competing with hospitals for basically the same skill set type of employee. So it puts a lot of pressure on the imaging centers that are still faced with depressed reimbursement for these tests.

Brian - Erinn, what kind of challenges are you seeing there at Stockdale?

Erinn Suadi, co-founder, practice manager of Stockdale Radiology - Well, we're finding that it's harder to retain employees, of course. Since 2020, employees have a different set of priorities in their personal lives, as well as their level of dedication towards their jobs. We, of course, have the same challenges as most of the large corporations that we compete against, finding physicians and qualified staff.

Brian - Lorenzo, you mentioned reimbursement and reimbursement has been really kind of on the chopping block lately. There's been a lot of cuts to Medicare reimbursement, and I'm sure that the private reimbursement has followed suit. How severe has the pressure on reimbursement been the last couple of years?

Lorenzo - It's been significant. If you go back to, and I think Aaron has these numbers. If you go back to, say, 2008, I believe that the conversion factor multiplier from Medicare was around 38, 39, and now it's 32.

So just to put that into context, an MRI of the brain would have reimbursed back then for about $1,000, and now we're getting about $300 for it. So the wages continue to go down, and that's if the RVUs stay the same. And as we know, the RVU values tend to drop over time.

For some reason, the work becomes easier, I suppose. But no, not really. So we're having the work is getting paid less consistently year over year.

And even from last year to this year, it wasdown, what, 2.3%, 2.5%. So there is no light at the end of the tunnel, itseems, for the revenue side. So this makes a really difficult environment forus to, especially with inflation, for the staff to, it's hard for them.Everyone's feeling the pinch.

Brian - Lorenzo, you mentioned staff. Aaron, can you talk a little bitabout the staffing challenge? Because another big issue that we've beenfollowing a lot at the Imaging Wire is issues with staffing.

And there's shortages with radiologictechnologists, there's shortages with radiologists. I mean, how severe is that?And how do you manage that?

Erinn - Well, we've been very fortunate to have staff who is, at least on the medical side, that are extremely dedicated and have been with us for quite some time. We do find that when we do have an opening, it's not a two-week turnaround to replace anyone. You are recruiting for a month or two to even be able to address that issue.

And especially in this area where, you know, we may be in California, but we are central. It's not an area that people think, okay, that's exactly where I'd like to live. Radiologists are definitely the hardest.

You know, you may get a very qualified candidate and get them here, and they don't necessarily fit in an outpatient environment. We definitely have more contact with our referring physicians, and they require a more personalized touch when it comes to delivering those results.

Brian - And do you think this is getting to the point where it's starting to affect patient care?

Erinn- Yes, absolutely. There is a large delay in our area. You know, each and every center, us as an independent and the larger entities around us all have large backlogs.

Brian - Wow. I can imagine. Lorenzo, what are some of the other issues that are coming along?

What about coding? You know, coding is so important to make sure that the procedures that you're doing are coded accurately so you can get the reimbursement. Are you seeing more claim denials?

Because one of the issues that's come up is that maybe people that aren't as technically skilled as maybe they used to be.

Lorenzo - Yeah, so coding is definitely a piece of it. I think that our denials, you know, we do have a lot of denials. I think that that's not so unusual.

But in a delivery unit like Radiology where the margins are low, you know, we talked about the revenues going down, the costs are going up. So, the margins are ever depressed. So, everything depends on doing things far more efficiently.

It's urgent now to do things efficiently, although we always wanted to do it. We always talked about it. We always, you know, that's always the goal.

It's becoming to the point where it's not optional anymore. We must find every opportunity to do things more efficiently or the denials just steal all of your margins. So, just in the last six months, you know, we're a small mid-practice here privately owned and just sitting on a half million dollars in denials that account for all kinds of things.

Contractual adjustments, patient can't be identified as our insured, wrong DX code. You name it, there's a lot of different things. So, you know, the coding is definitely part of that.

Part of it is just the complexity of so many patients coming in so quickly for a very low reimbursement. So, you must do rapid work and it must be clean. And that is the challenge.

Brian - You said half a million dollars in denied claims?

Lorenzo - Yeah. And that's just over the last six months. So, yeah.

So, these are things that I think every practice has, you know, every practice has AR they're dealing with. So, as we ,I'm looking at the number of participants in the call, I don't think that that's far, you know, that's not unusual. There's going to be a large AR.

I think the point of this is just to illustrate that there's an opportunity for margin to reclaim our margins with good processes and with better software solutions. And that's not so much an option anymore. It's absolutely a necessity.

And we have to find new tools to do this high volume, low margin work more efficiently than ever.

Brian - Great. Well, that's exactly what we're going to be talking about shortly. So, Lorenzo, can you walk us through Stockdale's process for patient intake, processing, scheduling, and, you know, it's so important to make sure that's all being done efficiently because that also affects how patients see your practice.

Can you kind of walk us through what you do?

Lorenzo - Sure. And I don't believe, I think we have some slides on this. I'm not sure that we have a process that's too different for most folks.

So, what we do is we have a couple of different things that we track. One is insurance. The second is the order.

And then we look at the order requirements. So, I might be able to show this if you need me to.

Brian - I was having trouble grabbing that myself.

Lorenzo - So, for our side, what we are trying to focus in on the first thing is what is the insurance plan that the patient has? Are we contracted with it? Is the patient eligible and identify who the guarantors are?

In our experience, those things are the first steps that must be done. You can work lots of different ways on this process, but in our experience, you don't really put the paint on the car until it's built. So, if you do things in the wrong order, you could waste some time.

And you don't want to do that. So, we'rereally looking to see what's the insurance plan requirement. After that, wecheck on the order.

Is the order complete? Does the order make sense? Are we given contrast to a patient where contrast could actually obscure the results?

Or did they not order contrast and we must have it in order to find what their doctor is looking for? So, we have a team that's looking for those things. Does the order make sense?

Does the DX? Does the diagnosis code? Is that a payable code for that test?

All these things must be evaluated in order to make sure you're going to get paid. Sometimes, the pressure is just do what the doctor ordered. Well, unfortunately, some of the providers aren't specialists in radiology.

They don't understand that what they're looking for is actually in a different part of the anatomy than what they are asking for. Plus, they're hard. They just don't know.

So, we're the experts. We try to guide them in that as kindly as we can. So, what's the insurance?

Are we contracted? Is the patient eligible? From there, what's the order?

Does it make sense? And then after that, does the insurance cover that test? So, it needs to be done really in that order.

And if you do it in that order, then you stand a much better chance of getting paid and you're maximizing your staff's time. So, there's no sense in looking at the test and checking to see if insurance covers it. If your insurance is not one that you participate with, you've wasted everyone's time.

So, if you do things in a certain order, you'll maximize your staff's efficiency. Gotcha.

Brian - Lorenzo, you mentioned earlier technology and IT tools that you think maybe can help address some of these challenges and some of the complexity here. What are some of the things that you think where IT can help?

Lorenzo - So, we have been on a hunt to find the best solution for this. But right now, there's some amazing things that are taking place with AI in ingesting the order, in taking this away from people. You need to find some tools that can read the order, select the patient, select the doctor, select the DX, do all of that work as much as you can, take it out of the hands of the people and put it into the system.

The tools that are going to get us there are going to be the ones that minimize the number of human hands that are in this. It's a lot of trust, right? So, I've used chat GPT and, bless its heart, it's great, but it can hallucinate.

So, we don't need to be picking out the wrong things and there has to be some checks and balances, but there's some really neat things coming. The technology must evolve to the point where we're taking some of these day-to-day things out of the hands of people and putting it in the systems. And if we can do that, we can minimize the training time and the time that we get somebody that's a new hire to the point where they're training to the point that they're fully functional.

If we can minimize that gap and put as much into the system as we can, that's really our goals.

Brian - Very good. So, Erinn, at Stockdale Radiology, you guys are looking at acquiring a new risk packs that is going to address a lot of the challenges that we've been talking about. Can you talk a little bit about that and kind of what direction you guys are going?

Erinn - We are actually, for the PACS system, we are at risk, we use RamSoft – and have been happily for 15+ years. We are actually looking at integrating some new front-end products. We are looking at a partner of RamSoft at the moment called Alpha Notice.

It's going to do some really amazing things. It will actually take the day-to-day challenge of having a human, a full-time equivalent, sitting here, processing an order, take the human error out of it. We're really excited about where the technology is going.

As Lorenzo was saying, you know, you're going to be able to actually reassign your workforce from having to do the mundane task. They're going to be able to be reallocated to customer service, and that's super important in an independent imaging practice. You know, they're going to know those big names that are out there.

They're not going to know the mom-pop shop as their first choice for imaging. But in a community like ours, if we are able to redirect our employees and not increase our employee footprint and reduce across the board, we'll get more accuracy with the software. We will not have to rely on should an employee call it sick or have a family event.

And we're hoping that having more patient interaction and not having mundane tasks that will increase our employee retention with having a more satisfying work environment.

Brian - Very good. Breda Drury with RamSoft, can you talk a little bit about the IT tools that RamSoft has available and maybe talk a little bit about Alpha Notice and kind of what exactly that does?

Breda Drury, Senior clinical product marketing manager, RamSoft - We're equally excited with the multiple new best-of-breed AI-based products that we are adding to our RIS/PACS product line. We hear the voice of the customer, and we know that we are working with Alpha Notice to bring automated eligibility, estimates as in cost of procedure, copayment, and insurance contracted rates to our platform and to our customers.

Having those figures at your fingertips would really help the customers. Also, all of this with minimal human interaction, the AI will automatically check prior authorization and it will look at the requirements. And then what is the current status?

That message will come over to the employee. They can look on the work list and they can see the authorization number coming through and the effective start date.

Brian - Very good. So I'd like to remind everybody out there, we'll be starting our Q&A session shortly. You can hit the Q&A tab at the bottom of your screen there to ask questions and we'll be answering those.

Lorenzo, does Alpha Notice sound like something that is going to address a lot of the problems that we've been discussing here on the webinar?

Lorenzo - Yeah, so we're still re-evaluating lots of different technologies, and Alpha Notice is one that we're looking at. I think that it's super interesting in what's coming because a lot of systems will say that they do automatic eligibility checking and some can even do authorization. They can go out and get the authorization on your behalf, and there are some insurances that support that, right?

So there are some insurances that will allow for you to automatically check eligibility. They have the configuration enabled to do that. Medicare, for instance, is great.

The challenge is not everyone does. And inCentral California where we're at, there are so many little HMOs, a Blue CrossHMO, that's some private type thing, and they don't always support those typesof things. And so because of that, you wind up with a split team, right?

You have a cohort that can do things automatically, and you have another cohort that you have to have a staff to go and do things manually. And so, essentially, you can't do that. You have to have, essentially, a team that can do everything because you don't really know what percentage of split you're going to have.

So what's super interesting with  Alpha Notice is that there are these amazing AI agents that can go out to the website, log in, read the website, and type into the website the data from the information system that it has.

That is just tremendous. And I think that's going to be a huge disrupter that we fully don't understand, I think, how it's going to grow and evolve and become even more intelligent than it is today. Back in the old days, in the 90s, when the speed of processors, Pentiums, and it exploded so quickly year over year, I have a sense that that's going to happen with AI.

And so what we see today versus what we see in six months is going to be kind of light year's difference. So I'm so excited about what's coming that it gives us the ability to see more patients more accurately and do better work. I can't tell you how excited I am to see this kind of thing.

So Alpha Notice is one of these– are we're pretty excited about what's available to us.

Brian - Well, if some of these AI-based coding solutions can help you dig into that half million dollars of claim denials, you're going to pay for software right off the bat right there, right? Sure. Well, that's very exciting.

So we're coming to the end of the panel discussion. We're going to have Q&A shortly. I just wanted to throw it out to Lorenzo and Aaron, maybe some tips to independent practices out there that are maybe looking at acquiring some technology to help with a lot of these stressors.

Erinn, what sort of advice would you have to somebody out there who's maybe facing the same challenges that Stockdale Radiology is facing and is kind of like, look, I got to do something differently here. Maybe I should look into IT. What would you suggest they do?

Erinn - I would take a very hard look at your practice. Start out with a list of the challenges that you're wanting to resolve. A lot of these products will have solutions for piecemeal portions of what you're trying to achieve.

And as we all know, each of these products come at a price. And, you know, that's why we've chosen to reach out to RamSoft and say, you know, hey, we need a one fits all solution. And they've taken that challenge and they're bringing in partners to provide us a one stop shop because it is important to have a somewhat level of fixed cost monthly to be able to budget.

And grow your practice from there. Know your practice. Know it inside and out.

Dig into every single denial and find out really where your challenges are. And then go out and hunt solutions and make sure that they fit everything. Vet it.

Because we all know every sales call is going to show you the best of their product. And then the functionality gets in there. Make sure you have a team that is going to be able to know every aspect of that integration.

I see so many independent practices where they just kind of trust what the product's going to do. And if you can really, truly vet everything that you're going to need and then plan for the future. Have a list of what your must-haves are.

Have a list of what would be on your gold star list. And you can truly see how much is going to change. I was one who was so against AI.

I thought you couldn't beat a human touch. And Lorenzo came and joined my team and has completely changed my mind. Completely changed my mind because I can really focus on patient care by making sure that, you know, faxes are processed, eligibility is done right.

And we all want to get a clean claim from the beginning. Because the more times you touch that claim, the more expensive itis to collect that money. And let's face it.

We are talking $30 for an x-ray and you're fighting for every dollar on an MRI. All of this becomes just integral to making it, making your practice successful.

Brian - Very good. And, you know, that's a great point. What you said is the promise of AI isn't just taking over a bunch of tasks that humans do.

It's taking over the mundane tasks and maybe doing them better so humans can focus on what humans do best, which is human-to-human interaction, right? So, Lorenzo, I'd like to get maybe some similar tips from you. And then, Breda, maybe if you can address some advice from the vendor perspective there at Ramsoft.

Lorenzo, what kind of tips do you have for somebody looking at doing more IT automation in their radiology practice?

Lorenzo - I think that Erinn, man, it's really a pleasure working with someone like her. So, I think that one thing we didn't really talk about is another tool that we're looking at is Maverick, the coding AI engine. And the nice thing about working with RamSoft is they really help us to do best of breed on these kind of things.

Maverick is an AI coding tool that we looked at, and they do amazing work. They're saying up to 97% accuracy on coding. And the challenge with Maverick is that we're not large enough to qualify to be a direct partner or direct customer with them, but they were able to work with RamSoft, and so RamSoft is kind of facilitating that relationship.

The nice thing about working with RamSoft, in our case, is they make a small practice bigger and put us into the conversation with some of these enterprise-level vendors like Maverick. And for Maverick, the goal of that is first-time payments becomes a lot easier because we don't have to pay an expensive coder to touch everything. And that's just a tremendous thing.

So I think that some of these things, like Erinn said, know your business. You must know what your denials are. You must understand what's causing them and start to attack your workflow based on what your denials are telling you.

They're your scorecard, right? So if you have a lot here or a lot there, it will help you break down where exactly your weaknesses are in your process. And that's really where you should focus your attention.

Brian - Breda, what sort of tips would you have as a vendor there at RamSoft? What sort of tips do you have for an independent practice looking at some more IT automation?

Breda - Yeah, so definitely be very close to RamSoft,to your customer success reps and your sales reps, and let them know what you find is valuable and what is useful. That will be used in an everyday, real-world environment. There's a lot of different AI out there and we’d love to show you what is available right now to make a difference to your practice.

And just finding one that really solves a problem and also will elevate the delivery of care for your facility. So definitely be in close communication and frequent communication on the solutions. You may not know of the solutions, but if you message, if we can hear your voice, what are the problems that you're having, we will be able to introduce a nice AI software.

Brian - Very good, very good. All right, so this brings us to our question and answer session. If you've got questions, please hit that Q&A button atthe bottom, and we're going to go till just a few minutes before the top of the hour.

Question: Where do you see disruption happening in this space?

Do you think that AI agents are enough to assist you on this journey? Lorenzo, you want to grab that first?

Lorenzo - Yeah, so I think that if you look at the current process of your paper faxes come in, your email orders come in, however you get your orders in, they all come in to a place, right? A team needs to ingest those orders. And when you do that, somebody has to look at that, understand it, and then translate it into your information system, whatever that means.

If you have an AI agent that can do all that automatically, quality can really do nothing but go up. Maybe AI would misread something, but the idea of AI is it can be programmatically scored, right? So there's a waiting that says, you know, how confident do you believe the AI agent is on identifying the patient's name?

How confident do you think it is in this match? You can tell it that you want to give more waiting on the date of birth and the spelling of the name, maybe the last name, maybe you want to include address. My point is that you can give AI all the tools to be as confident or as not confident as you want to give it, and you still present it to a human to confirm.

But it would do what humans are not good at, which is repetition in typing things in. We're not good at that, and the computer is much better at that. So I think that there's just a tremendous opportunity of disruption just in that one area.

AI can quickly scour through your database and find relevant matches, maybe have duplicate patients. So every order has an opportunity to improve patient care by ensuring that there's a relevant prior that might be compared to today's study. So there's just in one example of just inbound orders, you have tremendous opportunity for complete and utter destruction to the existing paradigms and absolute improvement in quality and accuracy in data entry.

Question: We've been talking about how great AI is and how it can do all these things and et cetera, et cetera. But what are some barriers to AI adoption and AI-driven workflow automation?

I mean, do you see maybe staff isn't psyched about it? I mean, Aaron, do you see any things that could kind of trip people up on the way to this kind of nirvana of AI workflow, enabled workflow?

Erinn - Absolutely. I mean, there's always challenges and fears that come along with a new technology. Honestly, our staff is really excited about it.

The sheer volume of faxes that we have coming in and having to go and check eligibility and say a patient is booked on the first of the next month, they have to go back and rework that case. You know, there is a fear that it's going to reduce the human workforce. That's not our plan.

We are at a point where we either add a lot, increase our employee footprint. So we're planning to implement and then redirect ours directly to customer service. I mean, there's challenges.

All of these AI softwares are cloud-based. What if there's an internet issue? There's also challenges.

What if the software goes down? Are your staff going to be well trained enough to survive without the software being available until it's back up? Even if you use chat GPT, chat GPT can pass medical board, but can it understand everyday process of your business?

You know, AI is emerging and emerging quickly. Is it going to be customizable to everybody's individual needs quite yet? No, no, it won't.

Will it solve a bunch of challenges that we're facing with employees and growing fast and having to be able to get patients in faster? I think it's going to help. It's absolutely going to help.

Brian - Lorenzo, what about you? What do you see as maybe some possible barriers there at Stockdale Radiology?

Lorenzo - Well, systems integration is always an important thing to look at. Will your solution fit nicely into whatever EMR system that you're using? The cost.

AI is a power-hungry beast. The computing cost and the number of processes that are available. Elon was just talking about the amazing things that they had to do to get the new version of your own cup and the 200 million or whatever GPU.

I mean, it's a lot of power. There's a lot of processing that's involved and it's not going to be cheap, but staff resistance and training, you know, will you have patient resistance? Will you have patients that will embrace having an AI agent call them?

You know, it may not be 100%. So I think that having the appropriate expectations of adoption, in all that that means, from your staff, from your referring providers, from your patients, all of those things must be considered and they can't be expected to be 100%. However, out of 100, if I can get some percentage to adopt and maybe have a growth curve of that, it would definitely help reduce my expenses on the other side.

So just because it's not 100% doesn't mean it doesn't have value. I think there's a number of different things that are some barriers, but they're also just things that you need to consider on adoption.

Question: Do you believe the future is cloud hosting or self-hosting in the case of medical imaging?

Erinn - Much to my dismay, it's probably all going to be cloud-based. We have chosen to self-host on a lot of things, but cloud-based seems to be where most of the vendors are going. So it's extremely important to have an infrastructure with whatever type of connectivity you're wanting.

It's not going to prevent you from needing servers on site and a really good infrastructure that protects you as well, but having an infrastructure that has backups and different ways to connect and ways to reduce your downtime.

Brian - Quick question that I just want to address, kind of housekeeping thing. There will be a recording of this available to watch on demand, so if you want to do that, definitely we'll be there. This is a really great question from Shabir.

For most businesses, consumer ratings and reviews are important. Many imaging centers get bad reviews for simple reasons, such as poor patient focus, poor communication or charging errors. I understand staffing is a challenge, so how can technology help?

I mean, that's kind of the theme of the whole webinar, but Lorenzo, just kind of in a nutshell there, what do you want to tackle that?

Lorenzo - Yeah, so, gosh, I wish that we could answer our phones faster. There's a large volume, and you just can't hire 3,000 people in a call center. So we have some limitations.

There's always going to be a supply constraint, and so some of those things, and that's just one example of somethings that can contribute to poor reviews. On the other side is, look, if you're going to have, like I said before, 100 orders come in, if you can use technology to help offload those somehow, maybe you send a text message out toa patient, let them self-schedule. Maybe you can use an AI agent that sounds just like a human, that can schedule without having to have a human do it.

Maybe the patient tries to self-schedule with your agent, and it gets complex, and they pull the record and they go to a human agent. Yeah, there's got to be this hybrid approach to allow for patients to have more time and attention for complex things. I think your chest x-rays and some of your screening mammograms that are fairly simple.

I use that word loosely.

Brian - Nothing simple.

Lorenzo - Yeah, but they're not like a multi-part nuclear medicine bone scan. But I think that some of these things that are fairly easy to self-schedule, self-manage, I think that stratifying these things into their different lanes and let patients self-schedule where it makes sense and then having a human will probably give the patient more attention. Then using the AI tools to identify what the testis and then coding it out so that it gets charged and paid properly the first time.

If we don't code things out and they get denied and the patient gets hit with the bill, that doesn't make them happy. So good quality work is good quality work throughout the whole process, not just in one part of it.

Brian - It seems like it might be really important that while you're having AI handle all these routine tasks, to give patients kind of an exit where they can get a human if they need it.

Lorenzo - Absolutely.

Brian - We've all been in that voice hell thing and there's nothing that's more aggravating than that. Erin, any thoughts on that front? How can we make sure that patients are happy as we're adopting these technology tools, how can we make sure patients are happy with what we're offering them?

Erinn - Well, absolutely. You have to remember on reviews that you are dealing with a patient base that is more than likely coming to you while they're worrying about a health concern. So I believe that the public realizes that when they're looking at those reviews.

So the best that you can do is provide the best customer service towards those patients. So them getting in faster, which AI is going to help do that. Their case being accurate.

A human could misread what a doctor's writing, AI will try and do its best and then only bring those exceptions to the staff here on site. Like I said before, freeing up from the non-patient facing tasks with the AI allows you to take your workforce and put it towards customer service. So the customer feels like they're being cared.

They can get in sooner. Their case is going to be accurate. Their eligibility is going to be accurate.

They're not going to be overcharged on their deductibles and co-pays. They're going to get their results faster with the solutions that we're looking at. We're looking at better patient portals.

We're looking at faster scheduling and get in there to get into the exam. I'm so sorry. And then we're going to bill it accurately.

So they're not receiving a strange statement. They're not having to call and ask us to explain why all of a sudden they're getting this bill because their assurance hasn't responded. AI isn't necessarily going to stop the reviews.

It's going to allow you to better manage the care so that you don't get the reviews in the first place.

Question: We are desperately in need of a front desk patient intake solution from RamSoft. What is coming in and when will it be available?

Breda - Please reach out to us at ramsoft.com or info@ramsoft.com and we’d glad to show you some really exciting options.

Question: What are you seeing as far as level of accuracy and productivity when transitioning to automated billing workflow?

Lorenzo - So this is what we do. And it's really important to breed this point earlier, if you're going to do an estimate, what are you going to do an estimate on? You really need to do an estimate based on what the exam actually is going to be.

So it's got to start with identifying the plan. You can't get an eligibility if you don't have the right plan. And if you're not contracted, you're not going to get paid.

So it has to flow, in my opinion, in this order. It would seem that you would, is the exam covered at the same time that you understand what the plan is. But if they are asking for a CT of the chest and they're looking for kidney stones, it doesn't really matter.

So you get the exam authorized for a CT of the chest. You do a CT of the chest, but that's not what they were looking for. You've not helped anybody.

So it really needs to be done in a certain order in order for you to optimize things. And the reason I bring that up is, the question was around building workflows. It's a garbage in, garbage out business.

So the more that you identify and record truth in your exam, from the very beginning, as quickly as you can find what the truth is, get it documented and pass it on down to the next member of the team, eventually to the tech, eventually to the radiologist. You're going to wind up billing the most truthful case that you have. And all of that means what the insurance is, the patient's name, how it's spelled, their date of birth, their member ID, all those things are part of truth, including the exam, CPT code and the DX.

It must be done all the way through. And if you can do that from the beginning to the end, by the time that it's ready to submit the charge, your billing automation will have a much higher rate of success than otherwise. And that's really the secret, is historically we just slam it into the billing company and then complain that our VCR isn't high.

We really have to understand what's causing our denials and work backwards at the start and start with seeking truth all the way through the first time. That is the hard part of this business, is it's counterintuitive, but that's how we make margin here. That's how we have to doit.

Question: Do you believe that shortening imaging times can lead to improved patient satisfaction scores and how important is that to you and are you taking steps to accomplish that?

Erinn - Shortening image times or shortening wait times?

Brian - It says imaging times. So maybe both.

Erinn - Maybe both. Well, who wants to sit in an MRI longer, right? I mean, if we're talking scans, absolutely.

I think a shorter scan time with AI assistance would make it less painful for the patient. But you have to walk that fine balance of convenience for the patient and quality of imaging. We have no intention of ever diminishing the quality of imaging or the level of care that our patients are receiving.

So, I mean, we are currently installing a new MRI. The software that's coming along with that is just absolutely amazing. It will reduce scan times, reduce anxiety for the patients, and not reduce our image quality.

And that's what we're truly looking for in any modality. As far as wait times, yes. I believe our competitor around the corner is three weeks out before they even call you.

You know, getting people in faster, getting answers to their health questions, assuring them that their baby's okay, making sure that they aren't facing cancer on a mammogram. All of that will increase patient satisfaction and making sure that we do it right. You know, all of it contributes to patient satisfaction.

And then, of course, having the most caring and professional staff when they arrive.

Brian - All right. Very good. So, I'd like to give everybody a chance for a few concluding thoughts before we wrap things up.

Lorenzo, can you kind of maybe tie a bow on every thing and maybe offer our audience maybe a couple things to think about as they kind of look forward to AI and IT-based workflow automation?

Lorenzo - You know, I think that, gosh, I think that the know your billing, understand where your denials are coming from, understand what's causing them is probably the start of truth for any practice. I think that AI has some amazing opportunities that's coming. Explore how those things can help you in your practice.

And I guess that the most important thing to remember is anything that you can get out of the staff's, out of their heads, out of their booklets, out of those things and into the system as a rule-based software feature is going to help to practice. The more that you have to rely on someone remembering things or going to a reference book, you're going to wind up with more errors that winds up with more denials. So, operationalize these things into the software solution and you're going to find amazing results.

Brian - Very, very good. Breda, some thoughts from you kind of to close out the webinar today.

Breda - Sure, Brian. So, RamSoft, we hear our customers. We see they're in perfect storm.

It's an unsustainable business mix with the rising operational costs, lack of skilled staff, high volumes and outdated work processes. And we are addressing them and we would love to hear how we can help you.

Brian - Very, very good. Erin, how about you? How about some bots to closeout the program today?

Erinn - Oh, my goodness. You know what? AI is exciting.

AI is definitely going to help a practice that doesn't have the same negotiating power as the larger corporations do. You know, this will definitely be an assistance to the type of care that we're wanting to. And we have an amazing opportunity because we can provide that level of care that the larger corporations can't with their corporate structure.

We can get back to the small town feel and still provide excellent care with this AI, but it's imperative that we do adopt it seeing as we're getting the lowest reimbursements in 30 years. And I think it's a 15% drop just from 2008. You know, we need to be effective.

We need to be efficient. And we need to put our employees where it really counts.

Brian - I love that how AI can help you get that small town feel back. I think that probably sums up the whole program today. Well, I'd like to thank everybody.

I'd like to thank our panelists, Erin Suadi and Lorenzo Michaels of Stockdale Radiology and Breda Drury of Ramsoft. Thanks for being with us today. We'd like to thank our audience.

Thanks so much for being on the program, asking such great questions. Just to remind everyone, this will be available for on-demand viewing and subscribe to the Imaging Wire to get a link to that. So anyway, thanks again.

I'd like to thank everybody in our audiencesigning off for the Imaging Wire. My name is Brian Casey.

Webinar Summary

The discussion focused on challenges faced by independent imaging practices and how technology, AI, and automation can help overcome them.

Key Challenges in Independent Imaging Practices

1. Declining Reimbursements
   
   • Medicare reimbursement rates have dropped significantly since 2008.
   • Private insurers often follow suit, reducing profitability.
 
2. Staffing Shortages
   
   • Difficulty in hiring and retaining radiologic technologists and physicians.
   • Rising wages make competition with hospitals more challenging.
 
3. Billing & Reimbursement Issues
   
   • High denial rates result in financial losses (e.g., Stockdale Radiology had $500K in denials in 6 months).
   • Complexity of payer mix and insurance eligibility challenges.
 
4. Operational Inefficiencies
   
   • Managing large volumes of patient intake, scheduling, and coding errors.
   • Need for automation to streamline workflows and reduce administrative burden.

Technology & AI Solutions

1. AI-Powered Workflow Automation
   • Reduces manual data entry errors.
   • Helps with patient intake, eligibility checks, and claim processing.
 
2. AI-Based Billing & Coding (e.g., Maverick AI)
   
   • Improves claim accuracy, reducing denials.
   • Enables smaller practices to function like large enterprises.
 
3. Cloud-Based Solutions & AI Assistants (e.g., Alpha Notice)
   
   • Automates insurance verification and prior authorizations.
   • Enhances patient scheduling and communication.
4. Improved Patient Experience
   
   • Faster appointment scheduling and result turnaround.
   • More time for personalized patient care.

Key Takeaways & Recommendations

• Understand your practice’s challenges and identify pain points in billing, staffing, and workflows.
• Adopt AI and automation to reduce administrative burdens and enhance efficiency.
• Vet technology solutions carefully to ensure integration with existing systems.
• Use AI to improve patient experience, not just reduce costs.
• Emphasize customer service, leveraging automation to free up staff for patient care.

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Final Thought: AI isn’t replacing humans—it’s enabling staff to focus on patient care and operational efficiency, making independent imaging centers more competitive and sustainable.

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