In this era of tight reimbursement and a shift in payment systems, labs are under greater scrutiny in regards to the quality of their Billing & Coding Audits. From the information they submit through codes to the denial of claims, it’s simple to realize that insurance companies are seeking ways to cut the pie even more thinly. To that, add the complexity brought on by COVID-19 as well as an outbreak of public health, and laboratories must navigate the most confusing reimbursement landscape that they can remember.
Laboratory Billing Solutions
Exploring RCM Through a Fresh Lens
What if there were real solutions that required only the use of a laboratory to examine their business processes with fresh eyes? Billing as well as RCM are typically approached using methods that are “tried and true” methods that have worked in the past. But, the current environment demands looking at business processes from a fresh and fresh perspective. Lab billing software provides many efficiencies and enhancements over traditional software that is based on paper and pencil. It not only has LIS integration and LIS integration, but it can also integrate with the electronic medical record system and EHR software.
Streamlining Coding and Billing
The perennial issue is how to create and submit claims that require the payment of insurance companies. How do you keep up-to-date with the multitude of updated, modified, or deleted codes? How can you make sure the claims you submit are submitted promptly and accurately? Instead, you can trust your support team to ensure the most effective billing and coding processes on your behalf.
Optimizing the A/Rs
Based on the Medical Group Management Association (MGMA) 50% to 60 percent of the claims will be left unattended, with revenues will be completely discarded. It could be due to an absence of time or knowledge. Reduce human effort in order to reduce the risk of human error. Automated Claim Status Follow-Ups as well as requests for follow-ups.
Laboratory Billing Solutions
Understanding the ways to automate medical billing is an essential requirement for every doctor and practice to make the right investments for an efficient business.
- Medical Transcription and Voice Recorder tools
- Auto-verification of insurance information and the demographics of patients
- AI-enhanced Computer-Assisted Coding System
- Automated Insurance Eligibility Verification
- Automated posting of payments
- Integration of EDI/EMR/EHR to Practice Management System(PMS)
- Reduce human effort in order to reduce the risk of human error
- Automated Claim Status Follow-Ups as well as requests for follow-ups
The latest versions of AI tools and medical billing software have improved the general approach to claim processing and revenue cycle management, resulting in various advantages like:
- More efficient claims processing, with a greater first-pass ratio
- Lower overall costs of operation and increased ROI
- A stress-free experience for billing and coding
A Billing and Coding Audit
Internal audits are essential to maintain the standardization and quality of services. Auditing Medical Billing and Coding files regularly monitor denials with recurrent as well as helps in reducing the denials at once. Auditing claims is the most effective way to correct denials of claims.
AR Follow-up and Denial Management
Denials of claims and focusing on the immediate steps to determine the reason for denial as well as corrections and re-appeal within the time limit for filing is required to ensure that the payments are collected promptly.
Experienced Billing and Coding Staff
A well-trained and effective billing and coding team result in better quality and fewer denials. Coders and billers who are familiar with specific guidelines for clients and related protocols can create more effective claims and better billing. Thus, having a solid and stable team is vital to any billing procedure.
Outsourcing the RCM Process
The current trend of increasing outsourcing billing is proof that outsourcing billing services are comparatively more efficient and profitable. The benefits of outsourcing your medical billing or coding to an expert billing specialist will result in improved financial performance while maintaining manageable operational costs.
Laboratory Billing Software
Lab billing software provides many efficiencies and enhancements over traditional software that is based on paper and pencil. It not only has LIS integration and LIS integration, but it can also integrate with the electronic medical record system and EHR software.
Here are a few additional advantages:
- Fewer elective surgeries
- Patients are more likely to comply with the prescribed treatment
- Greater patient satisfaction
- Improved patient education and knowledge of their health
- Patients have more positive health-related changes in their behavior
- Increased transparency is the result, leading to greater trust
Begin with Access to Patients
One of the most frustrating issues with the revenue payment process is accessibility to patients. This is the first point at which you receive a specimen, and the accessioning process starts.
Improve Laboratories’ Revenue and Reduce Overhead
Utilizing advanced automation tools can help a lab increase its profits, reduce costs, and put the focus on patient care. With reimbursement becoming more complicated and involved, testing becomes increasingly complex and insurance companies increase their use of control mechanisms such as advanced automation, prior authorization, and AI-driven systems are required to make sure that financial viability is assured. Contact us today to find out more about the possibilities available through RCM to increase the revenue of laboratories.