Every radiologist worries about dropped charges; that is, the radiologist performs or interprets a study, but the charge information is lost in the transfer from facility to billing company and therefore never sent out for payment (meaning the radiologist worked for free). MSN not only validates that concern, but we find and capture the revenue.  Most billing companies claim to regularly perform audits to ensure all studies read are billed out but very few do. As new clients transition from other billing companies to MSN, we consistently find “missed charges” are the cause of unrealized revenue. To address the issue of lost charges, MSN works with the hospitals, imaging centers and physician offices served by our client radiology groups to obtain comprehensive electronic or paper-based procedure logs. These logs are analyzed to make sure all procedures read by a radiologist are captured and processed by MSN’s billing system. While some billing entities conduct periodic “spot checks”, MSN implements a consistent, ongoing verification process. As a result, many clients experience an immediate increase in the volume of work billed out – resulting in more revenue for the work they already do.

Successful billing and collection of the optimum available payment for radiology services begins with the radiologists themselves. The key to success is accurate physician documentation – allowing for correct coding, billing and payment. MSN employs experts recognized throughout the industry to regularly educate radiologists on complete and appropriate documentation. MSN’s goal is to never “down code” any procedure for lack of complete client documentation.

Missing and incorrect information means claims submitted to payers will be rejected rather than processed and paid. Clean claims result in faster payments and fewer denials, so MSN employs several tools in its Imagine billing system and its claims clearinghouse, Availity, to “scrub” the claims to ensure the accuracy of information submitted to payers. MSN typically maintains a claims acceptance rate in excess of 99%, resulting in fewer denied claims and improved prompt payments for our clients.

Physicians and other healthcare providers are paid according to established fees by such entities as the federal government (Medicare and Medicaid) and commercial insurance companies. Each payer has a list of fees detailing what they have agreed to pay the healthcare provider for each service – and ensuring that what is paid matches the agreed fees is a critical part of the business of medical billing. MSN loads into its billing software the negotiated fee schedules for each client (as provided to us by the client). Our personnel can then analyze payments to ensure they agree with the negotiated fee schedules—and follow up with the payers when underpayment patterns are identified.

Many billing companies simply accept what insurance companies pay and adjust off claims for services that are denied, providing little to no effort to find out why a provider’s claims are unpaid. MSN believes these claims represent the marginal dollars that truly make a difference in a practice’s bottom line. Using dynamic worklists, MSN’s billing operation directs follow-up action on inappropriate denials, including researching medical necessity issues. When combined with the emphasis on clean claims submission, denials management helps ensure physicians are paid for the work they do.

High-deductible insurance plans and Health Savings Accounts have shifted the responsibility for payment to the patient – meaning physician practices must now deal directly with consumers for payment of healthcare services.  MSN has developed tools and programs specifically for consumers. We make it easy for patients to pay their bills by offering an on-line patient portal to verify insurance payments and balances owed, make a payment, submit e-mail questions or chat live with an MSN billing representative. Use of credit cards is encouraged to facilitate prompt payment, and monthly card payments ensure our clients take priority for patients on time-pay plans. 


Should accounts fail to pay, MSN works collaboratively with collection agencies to pursue payment, including an electronic download of information on overdue accounts to our clients’ preferred agencies. MSN also negotiates and implements “early out” processes, a service available from collection agencies. MSN monitors the collection performance of the agencies, while the client practice determines their preferred collections process and maintains established local business relationships.

Radiology billing requires software specifically designed to handle the large transaction volumes and complexities of this medical specialty. MSN uses the Imagine system from Technology Partners, a company dedicated to the development of radiology management systems for nearly two decades.  The Imagine system provides MSN with a host of capabilities both to process and analyze our clients’ accounts receivable, and to monitor MSN’s performance as the manager of your revenue cycle. Reports and dashboards provide immediate insight into all processes, and performance is measured against key indicators agreed upon with client practices. Added capabilities are available to our clients with AdvyzeBI, a sophisticated business intelligence tool to help physicians take their practices to a higher level of productivity and performance. Tools and technology help MSN achieve our ultimate goal – client satisfaction.

One of the first things MSN does with a new client is to analyze the billed charge fee schedule. We know from experience that refinement of the fees charged by your practice may have an immediate positive effect – and ensure no money is left on the table.


MSN was founded in 1996 by Bo Trotter whose experience in radiology practice management and billing dates to 1976. As the practice administrator of a 24-physician radiology group in Columbus, Georgia, one of Bo’s responsibilities was the group’s billing and accounts receivable management. MSN was founded as the result of other groups seeking Bo’s services in the realm of practice management and billing and accounts receivable management services. In 1990, the local anesthesiology group approached him about their billing and MSN was founded as the result of other groups doing likewise. Today the company has grown to over 160 clients and more than 500 employees. 


MSN was founded and is owned and managed by “in-the-trenches” medical business managers. No other company can match the talent and experience MSN brings to the table in support of its physicians. MSN not only understands how an effective medical business office should function, but also the day-to-day operational challenges physicians and administrators face. We speak the language of the medical practice and provide a wealth of resources to support the overall business of the group.  

MSN headquarters are located in Georgia, with smaller support offices distributed across the country. This provides responsive, localized points of contact for client practices. Operational personnel are extremely proactive and coding serves as a good example. Internal reviews and monitoring are ongoing and external audits are conducted annually by outside consultants. 

In addition, MSN is a private company, which means the sole focus is on supporting the business of its physician clients. MSN is not subject to juggling shareholder demands, such as percentage growth goals and higher stock prices. Instead, MSN is focused on meeting physician expectations of more accountability and increased revenues.

MSN estimates a billing fee based on each practice’s scope of work. Critical areas to consider in proposing a fee include average payment per procedure, payer mix; electronic interfaces and mix of modalities. MSN knows the billing fee reflects the level of resources physicians will allocate for collection of their revenues. Although MSN may not always be the least expensive option, experience shows the difference is more than made up for in bottom line results achieved.

No. MSN’s billing fee is comprehensive and includes all start-up activities.

Yes. During the onboarding phase, our coding staff evaluates physician documentation and provides feedback to all providers. Physician education is one of our strengths and MSN maintains an extensive library of coding articles, which may be either reviewed in client-specific meetings or accessed on demand.

Absolutely. There is a substantial correlation between contracts negotiated and the health of a practice’s bottom line. MSN can provide analysis of the potential impact of a particular contract; including how a specific fee schedule is likely to impact revenue based on anticipated volume.

Yes, MSN provides third-party insurance credentialing for clients’ staff physicians. There are also options for contracting for hospital privileging through MSN Practice Management Services. 

No. MSN start-up services are comprehensive and include all required equipment and software needed to establish data transfer, as well as upgrades and ongoing system enhancements. Subsequent changes to technology at service sites (requiring reconfiguration of interfaces) are charged to the Client at cost. 

Yes, our Clients meet with senior management on a schedule developed in conjunction with the group. For example, some groups see their MSN managers on a monthly basis and others quarterly, with the schedule developed based on the needs of the practice. These meetings focus on billing performance, identified areas for improvement, physician documentation feedback and advice on topics relevant to the physicians, for example the reduction in physician work RVUs and the resulting impact on Medicare payments.

MSN has invested in the Imagine billing platform, a state-of-the-art system developed by Technology Partners, Inc. (TPI). The Imagine system is designed specifically for billing of high-volume physician specialties and employs such features as distributed work lists to easily automate and manage workflow. It also allows for real-time management reporting and monitoring – quickly, easily, and on demand. Our close partnership with TPI allows MSN to focus its vast experience in medical billing on the continued development and enhancement of the Imagine software to meet the needs of our many clients.

MSN provides a robust reporting package to support data-driven decision making.  While certain standard data elements are included in each Client’s monthly reports, this information can also be customized to meet Client-specific needs and supported by agile report options to drill down regarding areas of concern. Performance measures are also reported over time to facilitate a rapid review of trends.   

In addition, some MSN Clients had complex data analysis needs beyond billing and collections. advyzeBI is available on a subscription basis for those organizations seeking to integrate data from multiple sources, including unstructured clinical data, financial and scheduling platforms.  

MSN offers a CMS approved Qualified Clinical Data Registry (QCDR) supported by detailed and timely performance feedback.   

  • MSN QCDR Clients benefit from the following services:
  • Monthly “Performance Met” percentage reports by group, physician and location
  • Number of claims where performance was not met with claims detail
  • Education about available measures and a review of changes, updates and documentation requirements
  • Choice of measures is at the Client’s discretion
  • Annual submission of quality and improvement activity data and CMS’ confirmation of receipt
  • Clients also have the ability work with MSN to develop new MIPS measures which can be submitted to CMS for consideration

MSN also developed an optional premium consulting program for Clients who want to dedicate themselves to achieving the highest possible incentives under MIPS.  This consulting program is in addition to the MIPS services included through the QCDR and as such, is priced separately. A sampling of the services included this program are: a) Client education sessions held twice per year to discuss the implications of the Proposed and Final Rules specific to their TIN(s); b) development of an annual plan focused on helping  optimize MIPS scores for all MIPS categories; c) monthly Client project meetings to analyze progress against the plan and adjust course as needed; d) interpretation of the semi-annual Cost and Quality data that drive MIPS scoring; e) determination of whether the Promoting Interoperability performance category applies, and if so, how best to optimize the TIN’s score in the annual plan; and f) identification of measures where performance is not met and assistance in correcting these to “performance met.”