This quick fix saved us from losing revenue and patient trust.

MRI Associates is a multi-site imaging group. In 2025 its team found that Medicare was being entered as the primary insurance on a large share of appointments where it should have been secondary: nearly one in three could show the error.

Where the revenue was leaking

Two things caused it. Patients often misunderstood their coverage and listed Medicare as primary, and the intake and booking team, working under pressure with nothing to flag the mismatch, entered what they were given into the RIS. From there the wrong payer travelled downstream: estimates were wrong, prior authorizations went to the wrong payer, and payments were delayed or denied. Appointments were rescheduled while the billing was sorted out.

Gravity's eligibility checks were already seeing the mismatch. They showed Medicare as secondary in many of these cases, but nothing carried that back to the RIS, so nobody acted on it.

What we did

We built the fix the same day. A workflow in Gravity checks every upcoming appointment against Gravity's eligibility results and flags the ones where Medicare is marked primary but should not be. Instead of re-auditing every appointment, the team gets one "Verify Medicare" worklist with only the likely cases on it.

The team confirms the coverage with the patient and corrects the entry in the RIS. There was no system change, no third party to wait on and no project for IT.

What changed

In less than a day the worklist was running, and coverage errors were being corrected before patients arrived, rather than discovered after the claim. Prior authorizations went to the right payer, and patients had fewer calls and reschedules.

MRI Associates did not need a new system. It needed the coverage fixed before the exam, and a team that could act on the problem the day it was found.