Times have changed every aspect of the healthcare industry rather drastically. Due to the rising demands of tests, verification and other laboratory services, federal, payers and regulatory bodies have introduced more stringent policies.
These complicated regulations have increased responsibilities for lab practitioners and reduced reimbursements for them. Despite this, new EKRA compensation laws, declining insurance payments, ever-changing medical billing and coding rules have simply let down many laboratories that have gone out of business.
Hence it has become clear to the laboratory practitioners that they need to adopt innovative strategies to combat these challenges at such times.
They must consult with medical billing experts to make their bottom line healthier. Before making any decision, providers first analyze their business needs and certain aspects of medical billing companies.
Here are the key factors that you should consider before outsourcing laboratory billing services:
Highly Specialized Lab Billing Company:
Every lab specialist comprises unique features. Therefore, a laboratory billing company should have essential resources and equipment to provide custom-tailored lab medical billing services that fit your requirements. After the implementation of the ICD-10 coding system, it has become inevitable to file medical claims by following highly specified medical coding protocols. As laboratory billing services are significantly different from medical billing services for other practices.
A highly specialized billing environment is an important factor to drive maximum revenue for your business. Therefore, well-reputed lab billing companies always offer uniquely composed billing services for every specialty. If you find that your existing lab billing partner lacks this feature then you should reconsider your contract and jump towards a better opportunity to save your practice from future hassles.
Well-Organized Data Management Systems:
A proficient lab billing company must be able enough to directly interface with your laboratory information system (LIS). Patient information is the most precious attribute of the healthcare industry. Therefore, your billing partner should follow regulatory guidelines to confirm the security and accuracy of information flow.
You may have heard about this phrase before that “Modern problems require modern solutions”. Therefore a lab billing company must have an electronic system to streamline the flow of PHI (protected health information) through LIS to the billing system.
Now, you might be thinking that can’t someone just key that information into the medical billing process manually? Certainly, yes_ but then following up with manual systems would become a time-consuming and burdensome task, isn’t it?
In simple words, you don’t have to make your resources always searching for information from the huge piles of papers and files, right? Although, it would also contribute to slow down the speed of your lab revenue cycle management services. Thus, in order to streamline your lab billing services, it is essential to shift towards innovative lab billing solutions and align your financial strategies with advanced business objectives.
Well-Experienced Workforce:
Having a discussion about LIS and information imports, every practitioner must know that no LIS provides patient information in the easily billable format. Therefore your billing partner should have a well-experienced and educated taskforce that knows every ins and outs of lab revenue cycle management.
They must have the required expertise to analyze which insurance companies require which kind of diagnosis codes and in what specific order to increase the likelihood of earning payment at the first billing attempt.
It is your primary responsibility to examine that a lab billing company has required an interface software system that automatically takes this information and loads it for billing, in advance to outsourcing billing services.
If you figure out that the answer is “no” then you will definitely experience lower revenues with such a billing company. Therefore, you should know the rules, process and your preferences to make certain decisions about your lab billing services.
Build a Profitable Relationship With Payers:
While on the subject of insurance specifics, a lab billing company should stay well-versed with nuances of every insurance payer. They should know exactly which insurance company wants which code set for your lab specialty.
There is a set of examples when insurance payers don’t accept claims for a similar set of medical codes for different specialties, while others have specific requirements for such codes. Although, there is no correlation between these codes. You should not even consider such a lab billing company that doesn’t understand the unique requirements of individual payers in your network.
Expert Analysis Of Medical Codes:
Speaking of medical codes, a professional lab billing company always has dedicated resources who analyze and test medical codes. These analysts understand your lab business to align the best suitable set of medical codes for your practice. It’s just not about the classification of drugs, they should readily be able to show you a detailed matrix of what medical codes will drive reimbursements when mentioned in medical bills.
If your billing partners are not well-versed with these norms then your partnership with an offshore lab billing company would definitely end up in less than optimal revenue generation.
Although, a reputable and professional laboratory medical billing company is always featured with technical resources, automates, processes engineers, and implements the best billing services for every laboratory they serve. These are just the top 5 key factors that you should consider before building trust for a lab billing company.
The fact is that reputable laboratory billing service providers have a multitude of resources and additional procedures that not only serve on the above-mentioned forums but also aimed at collecting increased revenue for your hard work.
Take Action Now!
Looking for a top-tier laboratory billing service provider to get optimized results for your revenue cycle management? Then look no further. Our lab billing industry leaders understand your business needs, appeal claims and take actions to collect maximum revenue. Click here to request a free demo for specialized billing services.