It’s not surprising that medical laboratories perform large numbers of tests each year. This is why they also have some of the highest denial rates within the healthcare industry. Many laboratories used to write off large numbers of denials years ago because they had strong budgets and substantial margins. They believed that submitting the claim was not worth the effort. Because they were making money, they didn’t care about losing money.
Sadly, these days are over, and every dollar matters. The market pressures and challenges facing laboratories today are forcing them to examine their own shortcomings and identify areas for improvement.
Laboratories have traditionally been seen as a backend process in the industry, rather than one that starts at the point of order origination. Backend billing is a missed opportunity for labs. Lab operators are starting to recognize the need to improve RCM workflow in order to avoid continuing trends such as payer reimbursement cuts and custom payer requirements.
Laboratory Billing Services
Here are some steps you can take to improve your lab’s first-pass resolution rate.
Maintain accurate patient files – Check each patient’s demographics and insurance information before they visit. Coverage limits change frequently as insurance carriers change. Labs will be able to submit more claims and have higher net collections if they take the time to do so at the beginning. This temporary fix will stabilize struggling labs and allow them to find and implement a long-term solution that will increase their ability to collect all claims with full visibility, while also minimizing labor costs.
Insurance Discovery – Contact the provider or client to get any missing, incorrect, or incomplete patient information. This will allow you to find the best commercial and government insurance coverage.
To verify that your insurance is active, check eligibility.
Whitepages Lookup: Log on to Whitepages.com and verify the name and phone number of your patient.
Validation of the USPS Address – Log on to USPS.com to verify and check the address of your patient.
Do not be late – Create a process to ensure that the claim is filed on the due date and that the payer has received it. Analyze the Results – Use the results to discover the reasons behind a claim and to learn from them to identify patterns. Keep up Rules and regulations change constantly. To stay current, take the time to train and educate staff.
Close the Gaps – If you don’t communicate your findings effectively to billing staff, front desk staff, and physicians, it is of no use to identify patterns or trends. You must ensure that everyone is on the same page and following the same guidelines.
Labs will be able to submit more claims and have higher net collections if they take the time to do so at the beginning. This temporary fix will stabilize struggling labs and allow them to find and implement a long-term solution that will increase their ability to collect all claims with full visibility, while also minimizing labor costs.
The Laboratory Billing Solution That Bridges the Gap Between LIS and RCM Systems
Although it is still in its early stages of development, the industry has seen a paradigm shift. A new connected back-end billing system is replacing the old disconnected one. This allows labs to start the billing cycle immediately after receiving an order.
Laboratory billing services that integrate Lab Billing and RCM ecosystems
Labs can integrate RCM functionality into their LIS workflow to streamline administrative tasks. They also receive real-time validation of key patient information such as address, demographics, and medications. insurance eligibility. The captured information can be instantly shared across the entire LIS & RCM platform. This eliminates the need for synchronization as well as the headaches associated with inconsistent data transfer across multiple systems. Ask us about Laboratory Billings to automate these steps and save you time and money.
This post is provided by Laboratory Billings, a medical back-office support services provider. We offer a range of back-office support services to US-based healthcare providers. This covers everything related to the management of revenue cycles. One of the areas we offer is the posting of payments. Our solutions have helped our clients improve their denial management, keep track of changes to policies, and gain access to expert consultants. Contact us right now to find out the details about our payment post-payment services.
