The problem
Slow or surcharged
Montana Imaging Center was built to challenge how diagnostic imaging is priced. Hospitals in their region charge $2,000–$3,600 for an MRI and send patients multiple bills weeks later; Montana Imaging Center publishes its prices openly: $800 for a knee MRI, radiology report included, paid in one transparent transaction. Transparency and flat-rate pricing aren't features for the company; they're the business model.
But on the back-office side, the system running their own outbound payments worked nothing like that.
Montana Imaging Center's Kalispell location is independently owned and operated by five partners, including Tate Kreitinger, who also serves as business manager. Tate brings 30 years of healthcare executive experience to the role, having served as CEO, COO, and CFO across critical access hospitals, regional tertiary centers, clinics, and ambulatory surgery centers.
Most of the company's outbound payments, bi-weekly distributions to partners and monthly fees to contracted radiologists, were running through the standard bill-pay tools their community bank provided. Slow, unpredictable, frustrating for everyone involved.
Those checks were probably taking five, six business days. Sometimes it would be up to a week. It was fairly unpredictable. It was hard to gauge.
Tate Kreitinger, Partner-Owner & Business Manager
The bank offered a “Rush” option to expedite delivery, but the math was absurd: $30 per transaction to receive a check only two days earlier, and even that timing wasn't guaranteed.
For a surcharge of $30 per transaction to get it two days earlier, and still not knowing when that day is going to be, is extremely frustrating. It's just crazy.
The unpredictability was a problem for everyone on the receiving end too: radiologists and partners trying to plan around compensation that might land in three days or seven. Even Tate's relationship with the local bank president couldn't help.
None of the bank people are going to be able to tell you when these checks are going to be received. They can't, because you're relying on the postal service. A lot of this stuff is typically outsourced. There's a lot of unpredictability that's outside of their hands.
The solution
Payments on autopilot
Tate Googled “ACH transactions,” found Nickel, and started with the free plan. He upgraded to Nickel Plus once he saw what the subscription added.
The subscription model gave us the form and function we wanted, at a price that others couldn't match. For the use and the product and the price, I didn't find it comparable.
Tate Kreitinger, Partner-Owner & Business Manager
Within weeks, Tate had moved Montana Imaging Center's entire bill-pay workflow to Nickel. What had started as a cost-driven evaluation turned into a deeper recognition. “After using and understanding the ease and pricing of Nickel, it felt complementary to my process.” Seven months later, more than $600,000 has flowed through the platform across 90 transactions: every routine outbound payment the company makes, including the $25,000 partner distributions that used to depend on the unpredictable timing of bank-issued checks.
Tate now knows when payments will arrive. Bi-weekly partner compensation runs on autopilot. Monthly radiologist payments process on a predictable two-day timeline. What used to take 15 minutes per payment is now a one-time setup that runs itself: no calls to the bank chasing down a check, no surcharge-driven decisions about which payments deserved to arrive faster. “With Nickel it's predictable. You know when it's going to be received. I could do everything automatically. It's been wonderful.”
With the bank, every payment was a choice: wait five to seven business days for standard mail, or pay $30 per transaction to expedite by two days, and even that wasn't guaranteed. Nickel removed the tradeoff. Every ACH transfer is free, and every payment arrives faster than the bank's standard timing without a per-transaction surcharge.
Montana Imaging Center runs their accounting on QuickBooks Online. Nickel transactions interface directly back into QuickBooks: no double-entry, no manual reconciliation. “It's easy to use, low-cost, and communication-friendly. I can swiftly and automatically complete transactions and interface them with QuickBooks.”
Montana Imaging Center works with radiologists in multiple states, including a specialist in Seattle. He wanted direct deposit, but also wanted to know exactly when payment had landed. “He said, ‘I'd love to get an automatic deposit into my bank, but I also need an email or some notification that I'm getting it.’ I said, ‘Well, that comes automatically once I make the payment.’ He was pretty thrilled about not having to deposit checks or try to think about when that check was coming in.”
Even Tate's personal relationship with the local bank president couldn't deliver answers when a check went missing or timing was unclear. Nickel changed that. “I had an issue that Callum helped me with via chat. He was very responsive and it worked out great.”
