Update Was Just What the Doctor Ordered

CRT Medical Systems evolves beyond
billing to range of business-process outsourcing options.

by Karen Dybis, Special to The Detroit News

If it needed a motto, CRT Medical Systems Inc. could say it is a patient's best friend.

That's because the Novi-based medical-billing company works behind the scenes to make sure patients' medical claims are paid quickly and correctly. At the same time, CRT ensures doctors, laboratories and diagnostic facilities receive their full reimbursement on that claim - something the medical community also can appreciate.

CEO David Doyle founded CRT in 1981 and developed its medical billing software systems, which it sold to doctors' offices for the past half century. CRT's 90 employees process $320 million in medical claims annually with 96 percent of its business in Michigan, Doyle said.

Now, Doyle is changing the company's direction. CRT has invested more than $850,000 in new equipment over the past two years to update its billing systems. Its new focus is streamlining the billing process, allowing medical offices to use its billing system or
outsource their entire billing departments.

Doyle's company also provides electronic prescriptions, helps with electronic medical record keeping as well as appointment scheduling and recall systems.

CRT's area of outsourcing—known as business-process outsourcing—is one of the fastest growing segments of the outsourcing market, said Richard M. Sneider, an outsourcing expert and director of the InterUnity Group in Concord, Mass.

"Every business should look at this option," Sneider said, which can help small businesses cut costs and improve performance over trying to hire their own staffs on what might be a shoestring budget.

Doyle said CRT is prepared for fast growth—he plans to boost its hiring through 2007 and double its size by 2010. Its expansion plans include moving into northern and western Michigan next year as well as acquiring other billing companies when possible. "The amount of change coming in our industry isn't stopping. It's accelerating," Doyle said. "That means we have to stay on the cutting edge of technology and be on the look out for opportunities."

Insurance companies in part are driving this change, Doyle said. They also are updating their software regularly and investing millions of dollars to scrutinize every medical claim that comes their way, Doyle said.

As a result, more claims are being rejected. Doyle pointed to a 2005 study that showed 26 percent of every claim coming into an insurance carrier is rejected. And 40 percent of those claims are never followed up on, which means they are never paid.

That is lost revenue for a doctor's office, Doyle said, and endless headaches for patients, who then may be required to pay that bill. Medical billing systems must be increasingly sophisticated to make the claims process work, Doyle said.

That is why he invested so much money in upgrading the one at CRT, which can track every line item on a claim to ensure it made it through the insurance company's intensive screening process.

The process is made that much more complicated because the rules on how insurance companies will accept a claim change so rapidly, Doyle said. CRT provides monthly training to help its employees keep up with these changes. And with about 250 insurance payers in the Metro Detroit region, that is a lot of items to track.

"We are providing a service that allows physicians to get what they're entitled to," Doyle said. "And when claims are paid, patients have less out of pocket costs."

Karen Dybis is a Metro Detroit freelance writer.

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