Outsourcing is a new way to run your laboratories’ billing department, and it is being implemented across the US at staggering rates. Laboratory billing can be a cyclical and repetitive process. First, a physician orders lab work for their patients, patients complete the lab work, the lab performs the tests and produces the results of the lab. But, then the lab is required to bill and try to get paid! Billing cycles range in length from several days to several months. Many offices have their own billing departments which can be costly and unnecessary.
The Laboratory Billing Cycle
To start a cycle of billing a physician sends off a specific lab code for the ordered lab work to be completed. The standard for billing is two primary sets of codes. Each of the two codes serve a specific purpose. The first code is known as the International Statistical Classification of Diseases and Related Health Problems or ICD. This code provides the framework for epidemiological codes. ICD codes classify injuries, diseases, symptoms, and all other complaints.
The second type of code is known as Current Procedural Technology Code Set or CPT. CPT is more to classify patients, coders, insurance companies, and medical providers. Both codes provide the insurance company or other payer the necessary information to determine whether to pay the claim. When the codes are sent, the lab collects patient payments and cycles it through the approval claims system.
Laboratory billing information is also beneficial for company growth. On a large-scale billing can calculate gross revenue per month compared to the activity of patients. This is known in many businesses as workflow. Workflow shows the amount of revenue your lab produces and how efficiently your billing department runs.
Laboratory billing can also have the opposite effect on your business. When your billing department is not efficient with their procedures it can lead to revenue loss. Unorganized claims, mistyped codes, and cash shortage are signs of a below average billing department.
Improvement Through Automation
Shortages of cash flow to your business will deflect any new equipment or office upgrades. Outsourcing billing is an effective way to approach laboratory billing systems. There are many benefits including improved cash flows. The US healthcare system pays billions of dollars to the heads of billing departments, reducing operating costs by outsourcing is a guaranteed cash optimizer. Outsourcing also reduces the chance of coding mistakes significantly. Automatic verification is another bonus to this way of billing. Mistyped codes and ineligible claims are the top two reasons for claim denials. Lowering these mistakes and reducing the number of staff in addition to the quicker processing time will guarantee more revenue making outsourcing the new hut choice for laboratory billing.
Outsourcing continues to show multiple reasons why it is a logical choice when billing. When lab billing is done incorrectly there are multiple ways cash flow and workflow can crash. Working with outsourced companies almost guarantees no mistakes, less staff, and more cash.
Credence Global Solutions provides end-to-end revenue cycle management and patient financial engagement tools to increase collections and time spent on collections. With over 200 years of deep industry domain expertise, our executive leaders have their fingers on the industry pulse and understand that our clients’ brand and bottom line must be protected and driven to levels not thought possible. Contact us today for a deeper dive into how we can help your business.