The biggest challenge that laboratories face is unsettled financial transactions due to an unorganized revenue cycle. These factors create a malicious loop that lab service providers find difficult to resolve. To handle a lab’s revenue cycle effectively, you must select a healthcare service provider who understands your needs and can address the challenges appropriately.
Here are some points to consider when selecting the right RCM partner:
· Will this provider help enhance cash flow?
· Will the partnership makes the operations seamless and structured?
· Will it help your practice focus on patient care?
· Will it help you take care of the training needs?
With the transition of the traditional healthcare model towards value-based care, enhancing the business’s financial workflow has become a necessity. Factors like attrition, unproductive processes and challenges related to Laboratory Medical Billing has made labs outsource their RCM services to secure financial success.
Overheads related to lab testing procedures, variations in reimbursement, regulatory imperatives and administrative workload exert pressure on lab establishments. And revenue loss due to these factors has started to affect most players. Therefore, the decision to outsource and the choice of a profitable Lab RCM partner takes on additional significance.
Why having a Lab RCM partner becomes crucial?
With a quick and efficient Laboratory Medical Billing process in place, labs can avoid the instances of write-offs and enhance their bottom line. It is natural for some laboratories to try and make in-house improvements to tackle issues like an untrained team, communication gap, and an inappropriate workflow. However, this may be a wise decision to hand over the responsibilities related to a Lab Billing process if you get lucky finding a competent partner.
Without a thorough understanding of the Lab Billing process, it is impossible to spot the best billing partner for your lab practice.
Here is a checklist that you can use:
· Selecting someone who provides the best ROI
Selecting a sensibly-priced vendor for billing services is vital, especially for smaller establishments that have constricted budgets. Investing in a third-party Lab Billing Service is not a wise judgment if you are trying to rationalize the financial workflow. When considering a potential Lab Billing partner, assess the collection costs which regulate your return on that investment.
· Varied Expertise
When crucial functions like Laboratory Medical Billing Services are outsourced, it is important to find a partner well-versed in handling issues related to billing and compliance. To avoid making errors, the outsourcing Lab RCM partner should have a thorough understanding of the Lab Billing Process.
· Denial Handling and Effective Claims Processing
A partner who can manage denials effectively can help enhance revenue in a better way. A Laboratory Billing Services partner should be capable of recognizing and overseeing trends in payments, and understanding and eliminating the root causes of denials by comparing the existing data with the previous one. Consider looking out for effective denial management skills to enhance revenue and speed-up payments.
· Turn-Around Time for the entire RCM process
Ensuring successful payment involves multiple steps. The Lab Billing partner you choose should be able to conclude everything within minimum turnaround time.
· Reporting Capabilities
Communication is important to stay informed about every aspect of your business. This helps improve financial matters and makes the selected Lab Billing Services partner accountable for the work undertaken.
· Customer Experience
Make sure to check the credentials of the firm you partner with. Research online and read up testimonials to see the satisfaction levels of their past clientele. Without any evidence of client satisfaction, there’s no point in outsourcing your Laboratory Medical Billing services to them.
· Technology and Support
Technology is yet another motivating factor when it comes to selecting a partner. The company you are selecting should have systems that are well-placed and solutions that well synchronize with yours.
A partner that has applications supporting billing through the latest ICD-10 transition can be easily integrated into your current billing system, and the transition will be much smoother.
Some questions to ask before partnering with a Lab Billing service provider
To make the decision-forming process easier, you can consider asking the following questions to a Lab Billing services provider.
· What abilities do you have to interface with your EHR, and lab system?
· Do you provide training during the on-boarding process?
· What is your approach to denial management?
· What percentage of your denied claims are appealed?
· What is your pricing model?
· How do you cope with patient calls and respond to questions from clients?
· Do your RCM solutions offer access to patient portals, appointment reminders, and reports?
· Do you charge additional fees for tasks such as pre-authorization and e-claims submission?
· Do you have dedicated account managers who are accessible to resolve issues rapidly?
The Road Forward
Once you get answers to these questions and the potential partners are narrowed down, you can go on to make a decision that’s ideal for your Lab practice. Make sure the agreement you execute with them indicates the services that are going to deliver and the staff who will interact with you.
Also, consider making your expectations apparent. If all goes well, you’ll have a seamless transition from in-house to outsourced Laboratory Medical Billing.
