Using automated technology or outsourcing services dedicated for labs helps ensure the lab's high-volume claims get reimbursed, according to Mike Fauver, associate vice president of product marketing at XIFIN, a San Diego-based health IT company.
Mr. Fauver shared the following tip with Becker's Hospital Review:
"Laboratory outreach billing is a high-volume, high-transaction environment capable of generating high profit margins. Yet many outreach programs use the hospital's revenue cycle management system and billing staff to process outreach billing, and a sizable percentage of these smaller dollar lab claims get written off to bad debt. Unfortunately, many hospital-based RCM systems don't have the configurability and payer connectivity required to maximize reimbursement for outreach services, or the financial reporting capabilities needed to measure outreach business performance.
According to the 16th Annual National Hospital and Health System Laboratory and Outreach Survey by Chi Solutions, of outreach labs surveyed, only 27 percent indicated they had access to true collected revenue, 80 percent do not know their bad debt, 23 percent write off all denials, and only 5 percent are confident they are collecting everything they can. To ensure the outreach lab is generating the most revenue possible, use automated RCM technology or outsourcing services designed specifically for the lab that provide analytics to measure your business, help reduce payer denials, and monitor discrepancies between paid and expected reimbursement. In particular, ensure that the system provides line item detail posting at the current procedural terminology code level that is automatically compared against the expected/contracted reimbursement to ensure that claims are not being underpaid."
Read more about RCM challenges in laboratory outreach here.
If you would like to share your RCM best practices, please email Kelly Gooch at kgooch@beckershealthcare.com to be featured in the "RCM tip of the day" series.