Most billing companies say they perform this task regularly, but MSN consistently finds “missing charges” to be one of the biggest causes of lost revenue as we transition new clients. MSN works with all sites of service to obtain comprehensive procedure logs, whether electronically or on paper. These logs are analyzed to ensure all procedures performed are captured in the billing system. It is important to note that this is not a periodic “spot check”, but a consistent, ongoing process—and in almost every case, new MSN clients experience an immediate increase in their billed procedure volume.

MSN’s coding staff, led by Walt Blackham, Renee Engle and Bethany Geiger, code based upon physician documentation. MSN provides ongoing feedback to its clients on the completeness and appropriateness of their documentation. Our goal is to never have to down code any procedure for lack of complete documentation.

MSN utilizes several layers of robust “scrubbers,” available both in the Imagine Radiology billing system and through its clearinghouse, Availity, to clean and validate billing data on multiple levels prior to submission. MSN typically maintains a claims acceptance rate in excess of 99%, resulting in fewer denied claims and improved prompt payments.

MSN loads negotiated fee schedules (if provided by the client) into the billing system. MSN personnel are then able to analyze payments to assure they agree with negotiated fee schedules.

Many billing companies accept what is paid and adjust off claims that are denied, providing little to no denied claims follow-up. MSN realizes these claims represent the marginal dollars that truly make a difference in your practice’s bottom line. MSN Billing personnel utilize dynamic worklists to guide follow-up action on inappropriate denials, including researching medical necessity issues.

MSN offers several options that make it easier for patients to pay their bills, beginning with an online patient portal that allows patients to make payments, email MSN with questions or chat live with an MSN representative. Credit card payments are encouraged to facilitate prompt payment.  

MSN works collaboratively with the agency of your choice in providing a download of information on overdue accounts. MSN also negotiates and implements “early out” processes with specific collection agencies in order to take advantage of tools available to them as an agency. We continue to monitor the effectiveness of the agency (and MSN) based upon collection performance.

MSN realizes competitive reimbursements that are based on a methodology other than a multiple or percentage of Medicare — a conversion factor with an inflation factor, for example. MSN addresses other contractual issues that impact billing and collections, including timely filing limits, ability to unilaterally change contract terms, and the comprehensive provision of procedures that require pre-authorization.

MSN’s utilization of a real-time relational database allows for true visibility into your practice’s performance on a continual basis. MSN employs efficient electronic processing and worklist oriented follow-up tools. Online patient payments help speed up and simplify the payment process and also allow online chat capability. A unique Physician Portal has been created for enhanced and effective communication between your physicians and our staff.

MSN analyzes each new client’s billed charge fee schedule and makes recommendations about possible adjustments to 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, Bo was responsible for 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 150 clients and over 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 that 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 with coding as a good example. Internal reviews and monitoring are ongoing and external audits conducted annually by outside consultants.  

In addition, as a private company, MSN focuses solely on supporting the business of its physician clients. MSN is not subject to juggling shareholder demands, such as percentage growth goals and higher stock pricesInstead, 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 views the billing fee as the level of resources physicians will allocate for collection of their revenues. Although MSN may not always be the least expensive option, experience shows Clients more than make up the difference in bottom line results.

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

All billing and accounts receivable management functions are handled in an established MSN billing office with trained, experienced billing personnel.  However, we are willing to discuss alternative options and related costs.

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 resources, 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 advises its Clients about prospective contracts by providing an analysis of the potential impact of a particular contract; anticipated volume and if current business is compromised; and the impact of a specific fee schedule.

Yes, MSN provides third-party insurance credentialing as part of its standard billing service agreements.  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 have complex data analysis needs beyond billing and collections.  MSN provides advyzeBI on a subscription basis for those organizations seeking to integrate data from multiple sources, including unstructured clinical data, financial and scheduling platforms.  

MSN is the only radiology billing company in the country to be approved by CMS as a Qualified Clinical Data Registry (QCDR) and highly recommends its Clients submit their MIPS data through this QCDR, thus allowing MSN to provide more detailed and timely feedback about “performance met” for each measure.

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 in 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.”

MSN Services