How Medical Clarity Changes PI Case Strategy with Cara Rosenthal-Knapp

If your case strategy depends on medical records, ambiguity can cost you time, leverage, and confidence.

In this episode of Judicial Dollars and Cents, you’ll hear from Cara Rosenthal-Knapp of Expert Radiology about how clearer MRI reporting, patient comprehension, and medical evidence can affect the financial side of a personal injury case. Cara shares how her work sits at the intersection of healthcare technology and law, why the first 90 days matter, and how a stronger medical record can help reduce uncertainty for firms, patients, and providers.

You will learn why medical ambiguity can stall cases, how patient-friendly reports can improve communication, how Expert Radiology is scaling a volume-based practice, and where AI may fit into radiology without replacing the need for specialized human expertise.

Listen to this episode of Judicial Dollars and Cents: How Medical Clarity Changes PI Case Strategy with Cara Rosenthal-Knapp 

Cara Rosenthal-Knapp, Expert Radiology. Cara is the founder and chief legal and strategy officer of Expert Radiology, where her work focuses on clearer medical reporting, patient comprehension, and the intersection of healthcare technology and law.

Connect with Cara Rosenthal-Knapp and Expert Radiology:

Website: https://www.expertradiology.com

Instagram: https://www.instagram.com/cararknapp/

Linked in: https://www.linkedin.com/in/cara-rosenthal/

Judicial Dollars and Cents, a podcast hosted by Anders Partner and Virtual CFO, John Scott, focuses on helping law firms win high-stakes cases with smarter financial strategy. The show breaks down the key metrics, financial frameworks, and decision-making systems that drive stronger case outcomes and firm performance.

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John C. Scott, CPA, AEP, is a Partner in Tax and a leader in legal industry financial strategy by Anders. He helps law firms win high-stakes cases with smart strategy by delivering clear financial insights, identifying key performance indicators, and strengthening decision-making at every level. With deep expertise in estate planning and financial analysis, John works closely with attorneys and firm leaders to align financial goals with long-term business success and case readiness. His approach brings scalability, flexibility, and data-driven clarity to complex legal environments, helping firms stay focused, prepared, and competitive.

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Transcript

SPEAKER_01 0:00

Welcome to Judicial Towers Excest, brought to you by Andrew's virtual CFO services team from all across the United States. I'm John Scott, and in each episode, we'll shine a light on the financial side of the legal world, turning law firm numbers into impact-driven stories. From taxes and profitability to practice growth and leadership, we sit down with law firm innovators who are shaping the future of the profession. Let's dive in right here on Judicial Dollars and Cents. Hey, welcome back to Judicial Dollars and Cents, the podcast where we dive into the business side of running a law firm. I'm John Scott with Anders Virtual CFO Services for Law Firms, and each week we talk with industry experts who help law firm leaders think differently about growth, profitability, and performance so they can build practices that last. Today we welcome Cara Rosenthal Mapp. Kara is the founder and chief legal and strategy officer of Expert Radiology, a rapidly scaling national radiology company operating at the intersection of healthcare technology and law. Her work centers on building systems that simplify complex information in environments where accuracy, credibility, and comprehension directly impact outcomes. Cara, welcome to the show.

SPEAKER_00 1:12

Thank you for having me.

SPEAKER_01 1:13

Hey, I love people's origin stories. So I'd like you to walk me through law school all the way to where you are today.

SPEAKER_00 1:22

Sure. Well, I graduated from law school what it feels like forever ago now, a couple decades it's been. Prior to law school, I was actually already sort of in my career. So I um decided to go back to law school. I actually went by night working full time in what I thought was going to be where I would work forever, which was in disaster response and recovery services. I was um director of government relations, uh, so kind of government strategy, positioning of contracts. And um then, you know, life happens and things change. I had, I got married, I had kids, I moved away to Puerto Rico, where where we live now. And um I had a consulting practice for a while and really kind of had to dig in and re-regroup and figure out, okay, well, now that I'm not necessarily on the ground based out of Florida and working for this one particular company, what should I do? So I went out on my own and they actually were my very first client. But through that work, I um sort of realized that I have this cool niche operation of knowledge and space in where kind of law, strategy, and really operations converge. So um a few years ago, I sort of dug into an area where I feel firms, particularly personal injury firms, struggle, which is operationally. So I got um my husband is Dr. Avery Knapp Jr., he's a neuroradiologist who's been in the medical-legal space for some time. And um I sort of basically I popped up a telemedicine company um a few years ago. And what I did was started triaging patients so that patients who were recently injured could get a good medical assessment and sort of be sent then onwards and on their way. And we we helped tens, tens of thousands of patients and very, very quickly in just a few years. But I realized it wasn't really um solving the crux issue that a lot of law firms have, which is setting that medical necessity journey in an in a um standardized, formatted, effective way that really moves the needle on settlements. So then I came back and joined forces with um my husband and came in-house for expert radiology. And over my time here, I've been working really closely on the personal injury ecosystem and discovered that the stallout with cases really doesn't isn't the result of bad lawyering at all. They stall because there's medical ambiguity at times, and um basically that impacts the financial side of a case lifecycle and their strategy completely. So um now I'm here working with expert radiology, pushing out a product that is uh game-changing, disruptive um MRI report. We didn't do it for personal injury, we did it for patient comprehension, um, for the advancement of patients everywhere to better understand their medical care. But the result of it is that it has a huge impact for law firms that use it because it's reducing time on desk, it's improving settlement values, and that's all cash flow that's really significant for a law firm.

SPEAKER_01 4:59

So the value proposition, if I'm a PI firm and engage your company to use your services, is that you can get a better settlement quicker.

SPEAKER_00 5:10

Yeah, I mean, really, um I'm of the belief and and and the data does demonstrate that the first 90 days of a case is really the where leverage for a firm is built or lost. And that really, when I kind of honed in, it really starts with the medical record. Um so yeah, the value proposition is if you have the right medical record from the very crux of your case and the very starting, the ultimate starting point. Um, you know, the inferred value beyond that is is tremendous.

SPEAKER_01 5:43

So I guess geographically we're not limited. If I'm in California or in Puerto Rico, if I sign up for your services and we get the MRI, you can do this all remotely, correct?

SPEAKER_00 5:54

Well, yeah. So for us, we're teleradiology, so we we can read for anywhere, anytime. Um, but the the real key is to go to know where the facilities are in your area that carry our report, or if if we're not in your area and you have you know existing relationships, we always encourage lawyers to make the intro. It's a pretty easy um sell. Hey, do you want to have more value for your for everyone involved and for all the advocates for the patient and the patient themselves? So we um yeah, if they get an MRI and we're the treating doctors for that facility, then they get the benefit of this report off the bat. Of course, they can also do second opinions and and we do those a lot and a lot of expert witness services. But the truth of the matter is if you have a very powerful singular objective piece of medical evidence from the very start of your case, you probably don't need us for a second opinion or anyone else for that matter.

SPEAKER_01 6:49

How have you grown and scaled this? How have you expanded from from when you started?

SPEAKER_00 6:54

Yeah, so I mean, we the practice started um decades ago. But um as a result of this new report, which is is really kind of what's what's moving and shaking the scales significantly, um, we've tripled in size in a year. Um we were already growing organically, doubling in size year after year for many years now. But since this report, we've had to triple our number of radiologists, growing every day. Demand and geographical imprint is it has been um widely expanded. And um and it's we've just gotten to interact with so many more patients and people. It's been great.

SPEAKER_01 7:37

So this is a family business. You and your husband, I assume you have other employees and contractors as well.

SPEAKER_00 7:43

Oh, yeah, we have um a pretty large practice now. Much, much, much larger than we ever imagined.

SPEAKER_01 7:49

So tell me about the pros and cons of working with your spouse.

SPEAKER_00 7:53

Oh, yes. Everyone always is curious about that. You know, it's there's I think that it's more pros than cons, at least in our house. Um, we luckily and fortunately tend to see eye to eye, and we are very good at um communicating without any sort of um, I don't know, like barriers or walls. I think when you work with a spouse, you know, maybe that's good or maybe that's bad. If you're able to receive all the information unfiltered, then um it can be a real value add. And I think in our household it is. It's hard to turn it off. Um, I always love when I listen to these like podcasts and other people that are like, oh, you just need to like draw a line and say, like Thursday night, we're gonna go to dinner and we're not talking about this or we're not talking about that. For me, that's incredibly unrealistic in our world. And so we are constantly talking about work, but it's kind of cool. You get to be with, you know, a sounding board all the time.

SPEAKER_01 8:47

How, if at all, and I assume you are, uh, incorporating artificial intelligence and process automation into what you're doing.

SPEAKER_00 8:56

Sure. So we get asked that a lot. And it's it medicine is sort of an interesting place. I think I think I was interviewed the other day and I said we're big fans of AI. I think that it is absolutely the wave of the future. Um for medicine right now, AI specifically in our field, it's just not at the level. Um, one of the things that we do as a practice that's um somewhat unique to our practice, we have an entire team of sub-specialized uh radiologists, and they read with an incredibly high level of sensitivity and accuracy. And AI just doesn't have that database of information at this time. So we don't use it in our reads um at the at this time. But I do think that there will be, hopefully in the coming years, a point where um it can be relied on and and more systematically and more consistently. And I think that uh, I mean, we hope to be at the forefront of that. We're certainly always looking at it and interested in collaborations.

SPEAKER_01 9:57

You know, I know a lot of PI firms employ nurses to go through medical records and evaluate and pull together information. And a lot of them are uh turning to AI tools, not to replace the nurses, but to filter through the 40,000 documents that the nurse needs to look at down to the most important things. And so I do think that's the the big differentiator in a lot of AI solutions.

SPEAKER_00 10:20

It can process so much information.

SPEAKER_01 10:23

Right. And it just helps them focus on what's important. Not that they don't need to consider everything, but not waste their time going through 38,000 documents that aren't important. Sure. I want to turn our attention to forecasting. How do you dynamically forecast your growth and and do you go through a process of forecasting what 2026 is going to look like three months, six months, twelve months from now?

SPEAKER_00 10:49

Yeah, of course. You I mean, uh information and and a direct plan and pathway is critical to any organization's growth, I would think. For us, um, yeah, we're always trying to, we we're always we're always analyzing what's been, right? So in terms of of our forecasting, we build off of what existed in the in the years prior. So as I previously mentioned, our growth has been tremendous and we've been scaling, you know, exponentially at this point. And so making sure that we understand what our our biggest um drivers and values are. And so um we focus in on those and we really prioritize making sure that those are attended to and built and we build our modeling around that.

SPEAKER_01 11:35

Yeah, I would think your revenue drivers are number of new cases, average value, and then of course your cost side is probably pretty predictable, right? Based on employees or contractors.

SPEAKER_00 11:46

Yes, our cost size, and of course, our cost size today is high because we employ doctors and doctors are, you know, a cost, a significant labor cost. But um, yes, it's it for us, it's a pretty much a volume-based business. So in that sense, making sure that volume, you know, continues to increase and improve at rates that are that have, you know, been proven year after year and that are sustainable, as well as ones that are goals. So we we focus on volume. And it's also for us um footprint, you know, we the more places we are, it's of course ultimately that would impact volume, but just the more available our reports are. Um so we're also focusing on like kind of just like new growth, new, new placement of the product as well.

SPEAKER_01 12:35

Are a lot of your doctors uh is this a a sideline for them? That so in other words, they have a practice and they do this or they do this exclusively?

SPEAKER_00 12:44

It's varied. Um they're they're all over the place. Most of them uh work full-time with us, but not all do. And um we're very, very flexible. What's very cool about um the way we've done our, you know, kind of hiring and our modeling, our our model for the radiologists is extraordinarily flexible. They can really work from anywhere, anytime, as much as they want. And so it gives a lot of freedom to the types of hires. Our our our biggest um barrier barrier is that we just can't hire them fast enough. And there's not enough radiologists to go around sometimes. But we once they join us, we we don't we don't lose them.

SPEAKER_01 13:26

Any plans or ability to expand outside the the footprint of the United States?

SPEAKER_00 13:32

Yes, we have been approached by international markets because I mean, uh putting sort of uh the law firms is somewhat tangential to us. For us, it's really about healthcare, right? Where we are in medical practice. And so we've been approached by, I mean, so many um other international markets to bring this patient comprehension model. Because what what what's unique about our report beyond besides just the high quality read and all kind of the other features? What's particularly uh special that we do is we created uh we got we hired hand, let me try that again. It's too early in the day here. Okay, we um uh we hired world-class illustrators, all the best medical illustrators we could find from quite literally all around the world to hand draw every possible, it's called a permutation, every possible outcome for you know, every sort of injury, et cetera. And so it turns out that this is like, I thought it was trillions, but someone told me, I don't know, like quantum millions. I don't know. There's like so many possible um combinations. It's it's incredible. And so anyway, we built a database that pulls together that particular patient's pathology and injuries in such a way that um it demonstrates your problem, not a sample, not someone else's, it's not generic, it's actually that specific patient's pathology and it's a medical illustration that's that a child can understand. So the impact in international spaces where medical care is very, very different than the US, is that it can communicate to a patient so much with so little extra burden placed on the medical system to explain it. Think about it. If you've been injured, John, you go, you go to a doctor, they say you need to go get an MRI, then like you maybe get that information back, you don't understand it, you're calling your doctor, you're asking questions, you're going into your doctor and requiring extra time to better understand and comprehend. But if you could have understood what the problem was the minute you got that report, you're gonna have a very different quality conversation and time and effective conversation with your medical care provider. So for international markets where it's even more burdened in many cases, their time with the doctor is more limited. This is a really valuable tool.

SPEAKER_01 15:53

Well, and you're right. Especially when you get an MRI and you have the 48 to 72 hours before you hear from the doctor, there's a lot of anxiety and angst that goes on during that time. I I'm very fortunate that my uh doctor's a friend of mine, so he usually calls me two hours later and says, Hey, you got nothing to worry about. Do I not everybody have that situation?

SPEAKER_00 16:15

You're exactly right. And obviously, being being married to one, I mean, this is what happens in our life too, right? People call and they say, Hey, can you look at this for me? Like, will you tell me I'm so nervous? And so, yeah, this patient comprehension is such an important element of medical care as we're like growing into the future. Um, hospital systems everywhere here and abroad are really focusing on it. Um, there's even higher reimbursements for this. It's just so important now for us as humans to be able to understand what's going on and the ease of those interactions. It's really significant.

SPEAKER_01 16:53

So realizing that technology is moving really fast, faster than we've ever experienced, what's the next innovation or iteration of your product or an expansion into a different service line that you anticipate?

SPEAKER_00 17:06

Yeah, sure. Um, so we've started with brain and spine because um the the largest number of MRIs performed every year are spine, actually. So that's where we started our practice, and obviously it's where we um are have had the most expertise, being that the practice was started by a neuroradiologist who specializes in brain and spine. Um so um that's where we started, but um, we we have a whole bunch of new body parts. We just rolled out knee illustrations last week, shoulders forthcoming. So the full MSK picture is coming. And then we also um have what we're really excited about is mammograms. Um, for that exact reason. Um patients, I I mean, you've probably not had to go get yourself a mammogram, but as a woman who has, it is so nerve-wracking to sit there and wait and hear that everything is okay or isn't okay. I mean, it's just such a they send you home sometimes with a, you know, a picture, like a printed picture, which is insufficient information from like an ultrasound, and you're like, what is that thing that I'm seeing here? And why is this thing red? And then you're trying to figure it out, and then you're completely misguided. Um, so we're really excited about mammogram. That's actually been the toughest one to illustrate, too. Very, very so many possibilities and so much to demonstrate in those illustrations.

SPEAKER_01 18:27

Well, and you're so right when you you get those partial results or you start to Google what might be. It's worse.

SPEAKER_00 18:33

It's worse.

SPEAKER_01 18:35

You go down a rabbit hole that's that's horrible.

SPEAKER_00 18:37

Oh, I I mean, I do it with my own husband. I'm like, okay, here's the symptoms, or even with our kids, you know, and I'm like, okay, here's all the symptoms, here's everything. I've decided that it's this problem and we need this medication. He's like, when did you go to medical school? And I'm like, uh, you know, he's like, stop, control yourself, you know, dial it back, call the pediatrician. Um, but you know, even I do it, and so it's it's what we all do. And so it the idea that we could have something that impacts that that process in in people's lives, it's just to reduce the number of worrying hours, you know?

SPEAKER_01 19:10

Well, we live in this world of instant gratification, right? Social media hits us with quick clips. Uh you go to fast food, you watch NCIS and they solve, they get the DNA back in you know two minutes instead of two weeks. Right. So it it hopefully uh you can provide that that quicker entry to information. That would be great.

SPEAKER_00 19:30

Yeah.

SPEAKER_01 19:30

Um what's the exit plan? I mean, at some point you're gonna grow and scale this, and somebody's gonna say, four, we'd like to have that.

SPEAKER_00 19:39

Oh man, I mean, people are already saying that we get asked this quite a lot, and we get we're getting all sorts of interesting calls. I guess when you're on what it was like the Inc. 500 or whatever fastest growing companies for a few years in the row. I think this year we were like this the seventh fastest growing like healthcare or something in healthcare, I'm not sure. And um, we don't really stock too much attention in those th those types of things, but other people do, it turns out. And so I don't know. We don't really have, we don't, I don't just fundamentally, we didn't build anything in our lives with the anticipation of exit. Of course, it's always there, but I think that our we we build we build things because we believe in them and we build things that we want to wake up and do each day and participate in each day. Um, I think that if you had told us, you know, even uh 20 years ago, whenever whatever, maybe 10 years ago, when when we really started down this pathway that we would have a practice with, you know, 24, 25, I think today, as of today or last week, um, radiologists that are not just any radiologist, but so specialized, you know, working with us and supporting our ideas and our goals and our dreams in themselves, you know, as a result of this amazing product, we would have like looked at you like you, you know, had 10 heads and an extra eye, you know, like we would have been like, uh, okay. Um, but I think when you get up every day and do something because it's what you want to do and you want to be building towards something, you know, I guess exit isn't really something we're we're focusing on, at least not right now.

SPEAKER_01 21:16

But you don't have any direct competitors, right? That do exactly what you do.

SPEAKER_00 21:22

There, I mean, there's lots of other radiology practices and other expert witnesses, but no that we there's no one else who has this report. And it um is patent pending. We're still waiting on the answer for that. I we thought we would have it last week. So um, but yeah, no, we are it is truly one of a kind and unmatched in its benefits.

SPEAKER_01 21:46

So you live and work in Puerto Rico. Where where do you where do you vacation? Since a lot of people go to your area to vacation.

unknown 21:54

Right.

SPEAKER_01 21:55

Where do you vacation?

SPEAKER_00 21:56

Um we like to go actually, I mean, obviously, anywhere with With like great history, Europe and whatever, you know, obviously, obviously amazing. But for in general, we like to go to cities because they're that's very opposite of what we have on the daily.

SPEAKER_01 22:11

So you want to go where the snow and cold is?

SPEAKER_00 22:14

Yeah, exactly. I love to ski. So anytime we can get somewhere cold that we can, you know, be outdoors skiing or active, that's great. Or um cities, you know, like New York and go see shows and go to all the restaurants and walk around, you know. I think that's the big the big takeaway, the ability to walk everywhere.

SPEAKER_01 22:33

So being from Puerto Rico, I gotta ask you before we wrap up about uh the Super Bowl. I assume you watched the halftime show.

SPEAKER_00 22:40

Oh yes, of course. I think I'd be kicked out of Puerto Rico if I didn't watch that halftime show.

SPEAKER_01 22:46

You are clearly a bad bunny fan, correct?

SPEAKER_00 22:48

Yes. Bad bunny song.

SPEAKER_01 22:51

Favorite bad bunny song that he sang at the halftime show.

SPEAKER_00 22:56

Uh-oh, you're putting me on the spot. I'm terrible. Favorite bad favorite bad bunny song ever. I can't say it. It has bad words. It has a bad title. It has a bad word title. But if you know if you follow Bad Bunny, you'll know which one that is.

SPEAKER_01 23:16

Well, yeah, I I'm sure my children know that that song.

SPEAKER_00 23:19

For sure.

SPEAKER_01 23:20

I enjoyed that. I enjoyed the halftime show. I I didn't, you know, I'm not bilingual, so I didn't understand it, but you know, you can get the dance moves and the the energy of it.

SPEAKER_00 23:29

That's really what Bad Bunny's about, anyway. I mean, words aside, it's just like any other, I mean, you know, we can think of any English speaking rap artist, and we can say that there's words that we can't say there or wouldn't wouldn't necessarily even follow at times. Um, but we can always feel the energy and the beat and the rhythms, and like I thought it was a visually incredible show, all the dancing and all the the kind of the way he built the set. And if you had seen his concert in person in Puerto Rico, it's all built with truly you can see scenes of Puerto Rico, current scenes of Puerto Rico. If you were to drive around, you'd be like, you could see that this was so reminiscent and so um representative. And I thought that was really cool to see.

SPEAKER_01 24:12

Well, and of course, the wedding at the time, I thought, oh, this was just fake. But then I I read afterwards that that really was a real uh wedding, that he invited that couple there to get married.

SPEAKER_00 24:22

He did. They were a real wedding, and I just thought that he really tackled so many, um, there were so many little parts and pieces of what he did that really are the way that things feel and exist. You know, it's like I think at one point you saw like the little boy like asleep at the wedding, like on the chairs because everyone was still dancing around. And this is this is like the, and at least in my experience, this is like the Puerto Rican um vibe, you know, the kids are everywhere, they're invited to everything. Um, there's there's no there, you know. I always love to say for my friends, I grew up in South Florida, and I love that you can go to like the nicest restaurant in Puerto Rico with young kids. And if they're misbehaving, no one cares, no one's upset, no one's disrupted by this. It's just like, yep, that's the way it is. That's life, kids, you know. And I think that's, you know, really one of the my most favorite, and one of the most beautiful parts of Puerto Rico. It's so family-oriented.

SPEAKER_01 25:20

So you don't reach over and pinch them so they behave.

SPEAKER_00 25:22

Well, I mean, I try, but my, you know, I mean, my kids, of course, they're perfect. They're perfect all the time.

SPEAKER_01 25:31

Mine were never perfect. They were great, but they're not perfect. I don't think that exists. Before we wrap up, Kara, Cara, um, how can folks get a hold of you and the company?

SPEAKER_00 25:43

Yeah, sure. I mean, the easiest way, if obviously you can find all of us readily accessible via our website, which is www.expertragi.com. Um, I'm available on all sorts of social media. I don't know if you'll be plugging in in places, but um uh obviously Instagram, LinkedIn. Um we on TikTok yet? I'm not on TikTok. My my my daughter is is pushing for this, but I'm a little bit intimidated.

SPEAKER_01 26:11

We we will publish on uh YouTube, LinkedIn Live, TikTok, and Instagram. So we'll we'll share that with you as well.

SPEAKER_00 26:20

Sounds great.

SPEAKER_01 26:21

Hey, thank you, Kara, for for joining us, and thank you all for tuning in to Judicial Dollars and Cents. If you enjoyed today's episode, be sure and like, follow, and subscribe wherever you listen to podcasts. It helps us grow and ensures that you never miss an episode. We'll see you next time on Judicial Dollars and Cents. Thanks for joining us on Judicial Dollars and Cents, presented by Anders Virtual CFO Services. If you found value in today's conversation, be sure to follow or subscribe wherever you get your podcast. To learn more about how Anders helps law firms strengthen their financial foundations and drive growth, visit AndersTPA.com. Until next time, keep making smart decisions that make perfect sense.