Whether you run a diagnostic, hospital or clinical laboratory one thing remains the same –– the need to maximize reimbursements and streamline operations. The quicker you can process claims and gather patient results, the better you can serve your medical clients while receiving payment promptly.

Lab Billing is More Complex Than It Seems

Laboratory billing seems relatively straightforward in concept. In a perfect world, you’d run the requested test results, define the correct codes, and then fill out and submit the necessary paperwork. Several days later, the insurance company would receive your claim and send you payment. Unfortunately, this is rarely how it works. Billing codes are constantly changing and red tape tends to get in the way.

When combined, these factors often slow down the claims and billing process. As a result, your laboratory might end up waiting weeks or even months to get paid. A certain number of delays are to be expected. But if all of your claims are flagged for incorrect codes or other errors, it can put a significant dent in your revenue stream. And without revenue, you can’t pay your employees or keep your laboratory running smoothly.

Our Outsourced Laboratory Billing Platform

Our outsourced laboratory billing platform can help. At Med USA, we have more than 40 years of experience assisting laboratories of all types with their revenue cycle management (RCM). Over the years, we’ve established a 99% first-pass rate, meaning that 99% of the laboratory claims we handle are accepted and paid out in a timely fashion. What’s more, we typically increase our laboratory client’s revenue by 10-20%. That’s huge, especially if your processing thousands of dollars worth of tests each day.

As you can see, outsourcing laboratory billing can significantly impact your facilities’ bottom line. Let’s take a closer look at some of our platform’s capabilities.

LIS Integration

Medicare beneficiaries who have a limited income often qualify for additional help through the low-income subsidy (LIS). Patients who qualify for the LIS through Medicare don’t have to pay deductibles or premiums. This is undoubtedly a beneficial service, but it presents challenges when submitting bills for certain laboratory procedures. Our laboratory billing experts know exactly what it takes to process LIS claims. This results in happier customers and greater efficiency. Additionally, LIS integration allows for a clean, fluid cycle of interoperability.

Laboratory EDI

The Laboratory Electronic Data Interchange is a program developed by the Veterans Administration. It’s an electronic application that automates the transmission of laboratory test orders and results between laboratories at the VA, Department of Defense, and commercial laboratories. Our laboratory billing platform includes a laboratory EDI framework. This allows us to streamline diagnostics and billing for the men and women who serve our country.

Eligibility Verification

One of the most time-consuming aspects of laboratory billing is eligibility verification. This is the process of determining a patient’s insurance coverage and benefits. It also ensures your laboratory will receive payment for the services provided.

Without a dedicated billing department, it can take hours or even days to track down all of the necessary information. This can negatively affect your processing efficiency and keep your team members tied up with administrative work. Our laboratory billing platform handles eligibility verification, allowing you to focus on what matters most: timely and accurate lab results.

Claim tracking

Outstanding medical claims are bills that haven’t been paid. It’s normal to have a handful of outstanding claims at any given time, but if the number balloons, you can lose out on a significant amount of income. Even worse? Losing track of those claims. Some laboratories have so many outstanding bills, they’re unable to organize or follow-up on them. This is the equivalent of flushing money down the toilet.

At the same time, it’s perfectly understandable. If you don’t have a dedicated billing team, there’s no way to stay on top of all the claims. Our laboratory billing experts can handle claim tracking for you. They regularly follow up with patients and providers to make sure you receive payment in a timely fashion.

Denial management

Billing denials occur when an insurance company or carrier refuses to pay for healthcare services. This can occur due to incorrect billing codes or manual errors like a missing date of birth or patient subscriber number. The industry benchmark for medical billing denials is about 2%, but anything over that may indicate financial problems for your laboratory.

Every laboratory receives billing denials on occasion, but handling them or responding in a timely manner isn’t always easy. Our laboratory billing experts can handle denials for you by staying in direct contact with insurance companies and the providers you work with. We provide both in-and-out of network claim denial management and resubmissions.

Outsourcing your laboratory billing comes with a variety of benefits. If you want to streamline your processes and continue to grow, it’s time to partner with the team at Med USA. Talk to an expert today to learn more about our laboratory billing services.

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