Last Updated on February 13, 2023 by Shams Khan
Is your laboratory practice struggling with constant revenue leakage? You should adopt proactive strategies to improve the laboratory billing services. Because lab billing is the backbone of healthcare revenue cycle management. Healthcare providers cannot maintain their long term existence without streamlining the cash flow.
As the current pandemic leaves a negative impact on the global healthcare industry and laboratory practitioners are facing a critical financial crisis in terms of revenue loss, cashflow disruption, etc. Moreover, their work schedules have also been changed and sometimes they have to ensure their availability 24/7.
Due to the lack of time, they face significant challenges when it comes to managing the lab billing and revenue cycle management efficiently. They are also struggling to adapt to the changes in insurance policies, billing, and coding rules. As a result, they end up frustrated, stressed, and lose a significant amount of their hard-earned revenue.
In such circumstances, laboratory practitioners find outsourcing lab billing services very beneficial for the financial health of their lab practice. Outsourced billing experts have the in-depth industry experience to manage the submission of medical claims in an effective manner. Which is essential to streamline the cash flow of your lab practice.
No doubt, the lab revenue cycle management is a challenging task for medical practitioners because it involves an array of healthcare stakeholders and complicated steps including medical coding, billing, denial management, etc. However, whether you prefer in-house or outsourcing laboratory billing services, you should know about the possible pain points of this process.
Here are the top 3 factors that can leave a negative impact on laboratory billing
Incorrect Patient Information
Proper documentation plays a major role in accurate lab billing and coding. It helps to prevent various complications during the coding process. Poor documentation leads to underpayments and denials.
Therefore, your registration staff should collect the following information carefully:
- Patient’s name.
- Date of birth.
- Address.
- Phone number.
- Email Id.
- Gender.
- Insurance Policy.
- Name of the plan.
- Payer’s information including name, address, etc.
- Insurance coverage.
If your registration staff doesn’t collect accurate information, it may cause a series of errors in the further procedure. These errors can lead to claim denials, which slows down the laboratory billing services. Therefore it is crucial to take immediate action to minimize such errors.
The best thing you can do is to train your front desk staff to collect the patients’ information accurately. In order to tackle the insurance ID card discrepancy, obtain a copy of the patient’s insurance card. Moreover, asks you, patients, to bring a copy of their state identity, so you can remove the errors that occur due to misspellings of names, incorrect address, and other documentation problems.
Inaccurate Medical Coding
Medical coders are considered as the invisible engines of lab medical billing services. Because they are responsible to extract information regarding patient’s diagnoses and treatments from the medical documents. Then they transform this information into standard medical codes. Medical billers use these codes to prepare the medical claims to get payment collections.
You must understand the fact that inaccurate coding will cause your medical claims to get rejected/denied or delays. In addition to this, it will negatively impact insurance companies and patients. Which can lead to patient’s mistreatment and slows down the laboratory billing services.
In addition to cash flow disruption, your lab practice may come under intense scrutiny for medical fraud and abuse. You can face serious consequences including federal penalties, heavy fines, and maybe imprisonment.
Medical abuse happens in the case of unbundling, upcoding and under-coding. When your billing team files claims which result in fraudulent monetary gain, either purposely or unintentionally. If you are continuously doing this misrepresentation of rendered medical services for a long time period, it is considered as a scam, fraud, or medical abuse. Which damages your reputation in the market.
So, in order to avoid such circumstances, laboratory practitioners should acquire the assistance of highly-trained and certified medical coders. It is also very important to keep your staff updated with the new or modified billing codes and guidelines. If you can’t manage this process in-house, you should outsource your laboratory billing services to a trusted third party. Off-shore billing companies have highly trained and well-experienced medical coders, who perform these tasks efficiently.
Filing Erroneous Claims
One of the major factors that negatively affect lab billing services is the late submission of erroneous medical claims. The most reasons for claim denials are including:
- Incorrect Patient Information.
- Submission of duplicated claims.
- Inactive insurance plan.
- Wrong coding.
- Incorrect modifiers.
- Lack of medical necessity
Medical claims, containing the above-mentioned errors are denied or rejected. Which hinders the reimbursements. You can overcome this issue by submission of clean claims in a timely manner. Lab billers should make sure that they are working hard to reduce the percentage of denied claims.
Laboratory Billings is the most sought-after destination for outsourcing laboratory billing services in the United States. That helps laboratory practitioners to optimize the revenue cycle management of their lab practice.
