01 · A marketing department on the RIS
Who is referring, and what it is worth
Clermont Radiology sells to referrers. Charla Hurst’s team calls on physicians and personal-injury attorneys across central Florida, and her reps log every visit. What she wanted was not a record of the visits (she already had that) but the money beside them: what each referrer actually sends, what it is worth when it is billed, and what the practice spends courting them.
So she looks at it daily: how many visits each rep made, which physicians are referring day to day, the expense against each one, and where growth is coming from outside the usual five to ten mile radius. The integration carried over 25,000-plus physicians from the practice’s EMR, MedInformatix, so the reporting started with the whole referral base already in it.
- Every rep visit logged against the referring physician
- Referral volume, expense and reimbursement in one place
- Reviewed daily, not at month end
- 25,000+ physicians carried over from their EMR at integration
02 · When the law changed
A whole market moving, visible in a week
Personal-injury auto work is profitable in Florida and it is where Charla’s team spends much of its time. When a new state bill landed, those cases started to fall away, and the useful thing is how she found out. She pulled her reps’ weekly visits and their notes, and the feedback was identical everywhere: referrers were seeing fewer attorney referrals themselves, and independent medical examination cut-offs were coming in higher.
That told her it was not one underperforming relationship but the whole market moving, and it told her within a week rather than at the end of a quarter. The response was a change of strategy: market to the attorneys directly, and point them at the providers worth working with, instead of pressing harder on the physicians.
- A regulatory change seen in the field notes, not the P&L
- The same signal across every rep, which ruled out a rep problem
- Marketing redirected to the attorneys rather than the referrers
- Days to a decision instead of a quarter
Why it matters
“I was able to see that right then: okay, it’s not just one provider, it’s across the board.”
Charla Hurst, Director of Marketing
Clermont Radiology
03 · Building the week around the payer
The schedule stopped being first-come
The same reporting changed how Clermont fills its diary. Tuesdays and Thursdays are the days a radiologist is on site for Medicare work, and the practice does a great many exams on them, for roughly $10,000 less than the other days. Once that was visible rather than assumed, it became a scheduling decision instead of an accident.
Mondays and Wednesdays now carry a protected block from three o’clock, and it is filled with the work that pays several times what Medicare pays: auto cases, clinical-trial patients, PET. The high-volume Medicare days stay exactly as they are; the rest of the week is built to offset them.
- Revenue per day understood by payer mix, not by exam count
- Medicare days protected, and deliberately offset
- A dedicated afternoon block for the highest-reimbursing work
- Some of it paying up to four times the Medicare rate
04 · The orders that never became scans
$228,000, and a $10 gift card
Charla does not only report what the practice completed. She reports what it was sent and did not complete, and why. In one month that came to $228,000 of orders that never turned into exams, a number that had always existed and had never been visible to anyone.
It is the most useful report she has, because it is not an accusation. It let her sit down with the scheduling and technologist teams with a figure rather than a feeling, and the idea that came out of that room was small: a $10 gift card for anyone who saves a high-modality exam from a same-day cancellation, no questions asked. In the first three weeks the team saved 23 MRIs. Her explanation is that nothing changed except that everyone could finally see what a saved scan was worth.
- Orders received but not completed, reported monthly with reasons
- $228,000 in a single month, previously invisible
- A conversation with scheduling and techs, backed by a number
- $10 per saved high-modality exam, no questions asked
- 23 MRIs saved in the first three weeks
05 · What the reps and the owner get
Commission you can watch, and a weekly snapshot
Two other things fell out of it. The reps used to wait until month end to learn what they had earned; they now watch revenue and collections as they land and can work out their own commission week to week. And because the report answers the question a referrer always asks: I send you fifty a month, don’t I? A rep walks into the office already knowing the real figure, and knowing how many of those orders the practice managed to complete.
The owner gets a weekly snapshot of high-modality referrers and what each rep brought in. Billing uses the same reports to forecast: a jump in one payer’s MRIs this week is money the practice knows to expect in 45 to 60 days. The custom report Charla wanted was built for her, after what she describes as a good deal of back and forth.
- Reps see revenue and collections in real time, and their own commission
- Referral claims settled with the actual number, in the room
- A weekly snapshot for the owner
- Billing forecasting 45 to 60 days out from payer volume
- Weekly onboarding calls, since relaxed to quarterly
Client story