New billing company sees opportunity in consolidated market

 - David Monaghan

Three regional billing companies have merged to create a new national billing company based in Salt Lake City, Utah, targeting radiology practices and hospital radiology departments.

The new entity, Medical Billing Experts (MBX), Salt Lake City, Utah, rolls up BOSS Medical Professionals, Salt Lake City, and two billing managed services organizations formerly owned by Charlotte Radiology (Six Seven Group), Charlotte, N.C., and Riverside Radiology and Interventional Associates (Premier Imaging Financial Services), Columbus, Ohio.

Dave Monaghan, MBA, former VP imaging services, Intermountain Healthcare, will serve as CEO, and Scott Roehrig, MHA, Jeff Fox, MBA and Karen Thompson as VPs of operations for the new company, with a combined 110 employees.

A shared billing platform, Imagine Software from Technology Partners, smoothed the way for the merger, but Monaghan also cites the consolidation in the radiology billing services space as a factor. “There are fewer options now for groups,” he says. “When it comes to players that are really able to deliver the goods for large groups and hospitals, I think the number of players has actually decreased.”

At the same time, revenue cycle management and the data available from billing operations have taken on greater importance as groups enter into more complex negotiations with payors, health systems and other organizations, he says. “For groups to be able to survive, they need to have sound billing,” he notes. “The world is changing, the future will be different and the people you are negotiating with will be different.”

Data are linchpin

Leveraging the data that billing provides will be a major focus for MBX. “Generally speaking, the billing system can be one of the best places for analysis, because it represents the final point in the chain of data,” Monaghan says. “You’ve already cleaned it, scrubbed it and codified it.”

Nonetheless, being able to comingle data from different sources—scheduling, accounting and billing, for instance—is a key competency for practices, he says. “In order to produce meaningful analyses, you typically need to take that final best source, which is billing, and combine it with some of the front-end input.”

Each of the three regional players brings individual strengths to the new national company as well, Monaghan says. “One was good at claims scrubbing and all sorts of denial management techniques; someone else was the patient-collections guru, trying all different kinds of tests and pilots on different ways of achieving the best patient collections; and someone else was great on call service and the patient satisfaction front.”

Likewise, each brought proprietary technology written around the shared billing platform that will now benefit all of the customers of the national company.

Monaghan notes that while the market for billing services is flat, new customers will be shopping for radiology billing services, primarily hospitals and health systems. “The employed radiology pool will continue to grow,” he predicts. “Hospitals and health systems are experiencing first hand that they maybe are not equipped to service those very well.”

The opportunity, instead, lies in moving away from the traditional transactional billing model to assume a more consultative role. “There’s a need, as the market continues to consolidate, to really provide good administrative services to groups,” Monaghan says. “In some cases, it will mean a deeper relationship with the groups in providing deeper analytics, getting involved in their operations, really understanding what they need to be successful and trying to provide that to them.”