Top 9 Tips To Deliver Error-Free Laboratory Medical Billing Services For Improved Revenue

Medical labs perform a critical role in the healthcare industry. Since they conduct large volumes of tests annually that help physicians, clinicians, and doctors make well-informed decisions for patient care services. There’s no surprise that there is ample room for errors and mistakes in the preparation of massive medical bills for healthcare labs.   

Therefore, some medical labs experience some of the highest claim denial rates. However, a study established that more often healthcare labs tend to write off a significant number of claim denials rather than appealing to insurance companies. 

Did you know? Medical labs can recover 70% of uncollected balances by simply rectifying their medical claims and appealing to insurance payers. If you believe that it is a difficult job to prepare new medical bills, manage claim denials and recover account receivables then you should focus on improving your first-pass resolution rate. 

It helps healthcare labs to streamline their healthcare revenue cycle management and improve their account balance. Although, it requires intuitive strategies to be taken in order to filter errors and mistakes from laboratory medical billing services. In this way, lab technicians don’t need to put a lot of effort in resubmitting claim denials and invest resources to work on the denials. 

If you don’t want to leave money on the table uncollected then you should read out this article till the end. 

With the rising inflation rate, practitioners should understand that every dollar counts. Now healthcare labs face several market pressures and challenges that are forcing them to look inwardly and evaluate shortcomings while identifying areas where improvements are needed. 

However, medical labs are often seen as a backend process rather than one that begins on the front end at order origination. Therefore, the revenue collected for healthcare labs is often considered insignificant. Only the significance of laboratory healthcare revenue cycle management and lab medical billing can shed a light on the significance of the profit margin created by healthcare labs. 

Because the lab billing procedure starts when the order comes into the laboratory not when the report is final. Therefore, lab operators have started to realize that they should proactively manage their practice revenue cycle management workflow. It helps healthcare labs to prevent their practice from excessive claim denials and rejections. It also helps them streamline their business operations and reduce reimbursement cuts, comply with custom payer requirements, pace with fast-changing lab medical coding rules, and manage patient payment responsibility with great expertise. 

Here’s how you can improve your lab healthcare RCM workflow for improved profit margins and reduced claim denials; 

Actional Steps To Improve Your Laboratory Medical Billing Services

It is important to eliminate errors and mistakes in laboratory billing services. With streamlined lab revenue cycle management, lab professionals can improve their finances to their fullest potential. With the following actionable steps, medical labs can streamline their lab medical billing and coding procedures; 

Collect Complete Demographic Information:

Missing patient demographic information accounts for most laboratory claim denials. Therefore, the front-desk staff of medical labs should accurately collect patient demographic information and verify if the information is also up-to-date. Healthcare labs that recognize the significance of patient charge capturing also identify the best lab billing solution that can help them eliminate the gaps and weaknesses in the patient registration phase. 

With cutting-edge EHR solutions, it has become easier for healthcare practitioners to collect patients’ demographic information from digital patient portals. With these portals, patients can enter their information lowering the work stress of laboratory staff. 

Maintain Accurate Patient Files:

Not only it’s important to collect patients’ demographic information accurately but it is also important to verify demographics and insurance information with each patient visit. Mostly, patients are unaware of their insurance plan, therefore it’s important to verify if the insurance plan covers their services. On finding the ineligibility of a patient’s coverage plan, healthcare labs should prepare patient bills and directly ask the patients to pay their dues. In this way, your medical billing staff would be able to identify accurate payment sources from the patient registration. 

Insurance Eligibility Verification:

After verifying the patient’s demographic information, it’s important to proceed with insurance eligibility verification. In this process, your lab billing specialists should verify what services are covered by the patient’s insurance plan. 

If there is any missing data, incorrect/ incomplete insurance information, or outdated coverage information then you should contact the patient to collect accurate information. It’ll help you identify the accurate source of reimbursements for the healthcare labs (i.e. either commercial or federal insurance coverage) so you can collect your payments without any hassle and excessive delays. 

Also, your front-desk staff should make sure that the patient’s insurance coverage plan is active. If not, then you confirm with the patients and use accurate insurance information. 

Lookup From Whitepages: 

If you’re still unsure about the accuracy of the patient’s demographic information then log on to Whitepages.com and verify the patient’s name and telephone number. 

Don’t Delay The Medical Billing Process:

It’s essential for healthcare providers to follow the timelines of each insurance payer. Submitting medical claims to insurance companies after the deadline cause claim denials. Therefore, lab billing and coding specialists should establish a process that ensures that the medical claims are filed on time and confirm that every insurance company receives your medical claims before their defined deadlines. 

Analyze Results:

If you’re continuously facing claim denials then you should take time out to study the reasons for claim denials in a detailed way. Analyze the claim denials, identify the reasons, and tune your lab medical billing cycle for accuracy and efficiency. In this way, you can optimize your lab healthcare revenue cycle management with useful insights and better agility. 

Stay In The Know:

It’s the responsibility of lab professionals to make their medical billing and coding specialists constantly learn and educate themselves about the latest rules and regulations of lab medical billing and coding. You can arrange monthly workshops, online lectures, or weekly meetings to share new findings about billing and coding rules with your team. 

Learn & Close The Gaps:

Regularly perform medical billing audit of your practice or opt for an external audit by any reliable lab medical billing company e.g. CureCloudMD to learn about the gaps and mistakes in your medical billing cycle. Identify patterns and trends to effectively communicate with your front desk registration team, medical billing professionals, and lab technicians. So they can align their office responsibilities in the direction of your business success goals. 

Conclusion:

By taking the time to go through these steps beforehand, laboratories can leverage more profit from their healthcare revenue cycle management. They can have more clean claims which will also increase their first-pass resolution rate. This short-term fix can help healthcare laboratories to stabilize their struggling payments, reduce their claim denials and implement an effective laboratory billing solution for the long term. Eventually, it can help them collect their payments faster and better. 

Using these insights, healthcare labs should deploy proper tools that can do beyond fundamental billing and coding tasks. In this way, healthcare labs can become more profitable, gain a competitive edge and constantly scale their business growth. 

If you’re struggling with constant claim denials/ rejections then you properly need a professional audit of your healthcare RCM. Fortunately, CureCloudMD is a US-based lab medical billing company that is offering a free external medical billing audit to all healthcare labs for a limited time. You can also get a free demo of our broad range of laboratory billing and coding outsourcing services.