Clarus Imaging experiences positive impact
from Centricity RIS/PACS-IW Solution
• 25 percent increase in volume at its three imaging centers by improving scheduling
to reduce idle time, add more time slots and see more patients per day
• Accounts receivable went from 60 to 90 days to less than 30 days
• 21 percent increase in collections from 2008 to 2009
• Strengthened competitive positioning by offering images and reports via Internet
to referring physicians
• Scheduling is more precise, billing is more accurate, claims denials and average days
in accounts receivable are down
• Native billing system in the RIS/PACS-IW Solution has DRA/OPPS Logic billing, which
submits the highest reimbursable study first in sequence on multiple studies, maximizing
the reimbursement rates
2. Clarus Imaging experiences positive impact
from Centricity RIS/PACS-IW Solution
• 5 percent increase in volume at its three imaging centers by improving scheduling
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to reduce idle time, add more time slots and see more patients per day
• Accounts receivable went from 60 to 90 days to less than 30 days
• 21 percent increase in collections from 2008 to 2009
• trengthened competitive positioning by offering images and reports via Internet
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to referring physicians
• cheduling is more precise, billing is more accurate, claims denials and average days
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in accounts receivable are down
• ative billing system in the RIS/PACS-IW Solution has DRA/OPPS Logic billing, which
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submits the highest reimbursable study first in sequence on multiple studies, maximizing
the reimbursement rates
Just two-and-a-half years after installing an integrated, “The return on our investment has been strong,” observes
web-based Centricity RIS/PACS-IW Solution, Clarus Imaging Kevin Herrington, Senior Regional Vice President with Altus
has seen a 25 percent increase in volume at its three imaging Health Management Services, parent company of Clarus
centers in and around Houston, Texas. Imaging. “Qualitatively, having an integrated RIS/PACS makes
us competitive with the other imaging centers in our area.”
That is the largest of many positive effects from the new
system, which is enabling Clarus to maximize its potential as “Financially speaking, greater efficiency means we are seeing
an imaging business. more patients per day and earning more revenue without
adding staff or increasing business hours. We’re capturing
Scheduling is more precise. Billing accuracy has improved. charges effectively and sending out clean claims, and so we’re
Claims denials and average days in accounts receivable are being reimbursed fully and in a timely fashion.”
down. Workflow is more efficient. The system provides a
centralized image archive and a single web-based reading
location for the firm’s radiologists, all of whom work off-site.
It also has a positive impact on report turnaround to meet
the needs of the referring physicians that support Clarus
Imaging. Centralized office functions facilitate management
of the three locations and provide a platform for easy
expansion (scalability) in the future.
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3. Gearing for growth “ know intuitively that this is
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Clarus operates imaging centers in Houston and nearby increasing revenue cycle efficiencies
Beaumont and Baytown, each specializing in advanced
MRI, CT and PET/CT diagnostics. The centers share space because we are capturing more of
with surgery and sleep centers owned by Altus Healthcare the CPT codes to charge to the
as part of its multidisciplinary physician network in the
Houston area, and is an official show reference site for patient or insurance company.”
Centricity RIS/PACS-IW Solution.
Kevin Herrington
When founded in 2004, Clarus Imaging had no PACS and used
a surgery center software package as their information system. Senior Regional Vice President
As the practice expanded, the need for a dedicated RIS and Altus Health Management Services
PACS became clear. Among other limitations, the scheduling
module did not fit the needs of an imaging practice, special
information needed in scheduling patients had to be recorded
on paper, images had to be pushed manually from device Boosting volume
consoles to the radiologists’ computers, and the charge
capture and billing process required error-prone manual, More efficiency in the scheduling process has a direct
paper-based steps. correlation to throughput, and that is where the new system
had its greatest impact. Previously, scheduling was inflexible
“The key driver in pursuing RIS/PACS was to get our and error-prone. An exam slotted for less time than actually
images archived and easily available to physicians in the needed could put the staff behind schedule for the rest of the
community to be on a strong competitive footing with day. Too long an exam slot meant wasted time. Schedulers
hospitals and imaging centers that were rolling out PACS now can access the database of physician, patient and
at the time,” says Herrington. insurance demographics already pre-populated into the
system. That helps with consistency and accuracy in
scheduling, which in turn has a direct correlation to billing.
Smooth transition
Exams are CPT-coded in the RIS down to the specific location
After an extensive year-long evaluation process, Clarus and scanner where it will be performed. So long as the
Imaging chose the Centricity RIS/PACS-IW Solution from GE scheduler selects the correct CPT code for an exam, the correct
Healthcare. This integrated, web-based system is designed exam time is automatically assigned – guesswork is eliminated.
to help ambulatory imaging businesses including outpatient
imaging centers, complete the patient care cycle smoothly “If we enter into the RIS that an exam takes 45 minutes,
and reliably, follow established best practices, and enhance we know that’s how long it takes and that’s how it gets
workflow and revenue cycle efficiencies. scheduled,” notes Rebecca Bridwell, MR/CT Technologist
and RIS/PACS Administrator. “It enables us to put patients on
The selection process involved mainly Herrington, Altus COO literally back-to-back appointments.”
Kraig Killough, Altus Vice President and Administrative Director
Sourabh Sanduja, and the imaging technologists. That means idle staff and scanner time is nearly eliminated,
Herrington observes. “Ten minutes here and 15 minutes there
The system was implemented in two phases, the PACS in two adds up by the end of the day,” he says. “By reducing idle time,
months ending in March 2008, and the RIS in July of that year. we’re able to add more exam slots and see more patients per
GE representatives served on the implementation team. GE day. We have seen a 25 percent increase in volume because
led phone conferences and web meetings to prepare the staff we’re able to schedule more accurately.”
for the process, then provided staff training on the system and
sent specialists to the Clarus sites for several days to assist
with go-live.
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4. Scheduling agility Other benefits of the
Centricity RIS/PACS-IW Solution include:
Cancellations can be a huge burden to outpatient imaging
businesses. At Clarus, the system helps the staff act nimbly in Physicians better served. More available time slots
dealing with cancellations. Schedulers have easy access to means referring physicians can have their patients scheduled
contact information and call the day before exams to remind sooner. The system automatically faxes reports to referring
patients of appointments. If a patient calls and wants to physicians as soon as they are transcribed and signed off by
postpone, the scheduler can easily see other available time the radiologist. This helps Clarus Imaging meet referring
slots and simply drag-and-drop to make the change. physician expectations for timely reporting. Physicians can
log onto the integrated RIS/PACS and review their patient’s
In addition, technologists can more easily move patients current and historical images, as well as reports – a point of
around in the schedule in response to cancellations or differentiation for Clarus in its market.
no-shows. “With the old system, we would have to go find
the patient’s chart, or ask scheduling to do so, and that would More accurate billing. The previous system included CPT
take time,” says Bridwell. “So if you wanted to move the next codes for a large number of procedures, inviting selection
patient up in the schedule, it wasn’t possible because finding errors. “Typically no one would catch those errors, and we
the chart and contacting the patient ate up the extra time would end up billing out inaccurately,” says Herrington. “Now
you had.” we build into our database the CPT codes for only
procedures we actually perform.”
Now, with contact information at hand, it’s easy to reach
the next patient and ask him or her to come right in, or ask More charges captured. The billing system in the
end-of-day patients to come in early, creating later openings RIS/PACS-IW Solution has DRA/OPPS Logic billing, which
that schedulers can fill. “It definitely helps our schedule submits the highest reimbursable study first in sequence on
management,” Bridwell says. multiple studies, maximizing the reimbursement rates. The
system electronically captures charges for all CPT codes
Smoother scheduling also means less time spent on the phone required for a procedure, as well as additional billable items
with referring physician offices who regularly schedule such as laboratory work and supplies. The technologist enters
appointments. “The less hassle it is to schedule a patient, the them to the system at the time of the exam instead of having
more likely a physician office will continue to refer people to to record them on paper for later manual entry in the back
us,” says Herrington. office. “I know intuitively that this is increasing revenue cycle
efficiencies because we are capturing more of the CPT codes to
charge to the patient or insurance company,” Herrington says.
Claims processed quickly. Accurate billing reduces claim
denials, and accurate patient and insurance information, also
captured in the system, has the same effect. “The computer
system is a closed loop,” Herrington says. “Everything is
electronic. All the information is as accurate as possible,
and we don’t rely on one person on the back end, a day or two
after an exam, to key in the information.” The system
automatically sends completed claims to a clearinghouse
where they are scrubbed before submittal to Medicare or
private payers. Claims denied because of errors are easily
corrected in the system and resubmitted.
“We’re being paid for procedures in
the same month we bill them out.”
Kevin Herrington
Senior Regional Vice President
Altus Health Management Services
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5. Revenue moved forward. “Days in accounts receivable have Workflow streamlined. “Technologists like RIS and PACS
been significantly reduced, “ says Herrington. “We are billing integration,” says Bridwell. “If we need to look at a patient’s
out as soon as we have all the necessary claim information, previous exam and sign on to the PACS, the RIS transfers the
and the insurance companies are paying us very quickly, report over, so we don’t have to jump between systems to see
because we’re sending clean bills, with no errors and no a previous report. We can just stay in the PACS and manage
issues. We’re being paid for procedures in the same month we the patient’s exam from there and pull up any previous reports
bill them out. Under the old system, we typically saw 60 to 90 we need. And because it’s web-based, I can manage studies
days in accounts receivable. Now we’re pleasantly surprised at from my home computer if I need to, instead of having to come
times to see less than 30 days.” in to take care of issues.”
Patients served quickly. Patients in general get in and out Reports add value. The system can generate more than
quickly because scheduling is precise and because the system 100 standard reports to help the business and stay on track
helps staff members track patients’ progress. “When patients with short- and long-term goals. “The reports give us a really
arrive, the technologists know they are here and ready,” says good understanding of our volumes for each procedure,” says
Bridwell. “We’ve always been really conscious of patient wait Herrington. “I also like being able to run a report showing what
time, and Centricity RIS/PACS-IW Solution has a tracking we are being reimbursed for procedures on average, all the
system built in. We know when we see certain symbols on way down to the CPT code. If we find out, for example, that MRI
screen that a patient has been waiting for an extended time of the brain is especially profitable, then we can step up our
and we need to see what is going on.” marketing to neurologists.” Reports also help managers track
referral patterns, detect when referrals from a given physician
or group are declining, and have a marketing representative
make a call.
Looking to grow
Herrington sees Centricity RIS/PACS-IW Solution easily scaling “One of the strong points for the Centricity product is the
up as Clarus Imaging adds more locations. “As we build more ongoing support. Although GE is a large company, we have
imaging centers, we’re going to use the same system and grow received personal service. It’s not a question of calling an 800
from it,” he says. “The centralized functions make it a natural number and talking to someone in another country for
basis for expansion.” technical support. We’re able to deal with people we’ve met
before. We have their cell phone numbers, they’re available to
He advises organizations considering RIS/PACS to review us, and they have been highly responsive to our issues.”
and compare offerings carefully. “Be careful working with a
vendor that hasn’t proven itself, even though the price may Centricity RIS/PACS-IW Solution has provided Clarus Imaging
look appealing,” he says. “There could be hidden costs. And a centralized business platform to improve performance in
remember that buying and implementing a system is only a wide range of critical areas, and to extend high-quality
part of the equation. Once you’re up and running, what kind imaging services to more communities, more patients, and
of support will you have?” more referring physicians.
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