Hand writing Revenue growth graph on chalkboard
The average American household spends roughly 8% of its income on healthcare.
Lab revenue cycle management is an essential part of running a successful laboratory. If you are under-collecting on your accounts receivable, you are losing money owed to you every day your invoices go unpaid.
If you neglect your business invoices, you are likely missing out on cash flow. Working on it is the only way to perfect your revenue cycle. If you need help thinking through your Laboratory’s revenue cycle management strategies, keep reading.
The Importance
The revenue cycle starts with patient registration and ends when the claim is paid or denied. To keep the process moving, you need to track every step. It includes knowing who your patients are, what services they received, and how much they owe.
Laboratories bring in revenue through testing services ordered by physicians. The types of tests collected will dictate the type of equipment and supplies needed and the number of staff required to perform the test. To ensure you are being reimbursed correctly, you need to stay up-to-date on the constantly changing coding and billing regulations.
To do this, you must have a good customer service team. The most crucial part of revenue cycle management is ensuring your patients are happy. If they have a good experience, they are more likely to return and recommend your Laboratory to others.
The Benefits
RCM aims to ensure that all laboratory procedures are coded correctly, that claims are submitted promptly, and that payments are received as quickly as possible. RCM also includes denials management, which is the process of appealing denied claims.
There are many benefits to implementing an effective RCM system in a laboratory. Perhaps the most obvious benefit is that it can help the Laboratory receive payment for its services. A well-run RCM system can also help the Laboratory avoid denials and appeal to any denials that do occur.
Additionally, RCM can help the Laboratory improve its cash flow and better understand its financial performance. Laboratories that take the time to implement an effective RCM system will be rewarded with improved financial performance and a better understanding of their business.
Tips and Tricks
Running a laboratory can be tricky- there are so many moving parts and pieces to keep track of. Revenue cycle management is critical to maintaining a lab running smoothly and efficiently.
Keep track of your payer mix and ensure you get the right combination of patients. Use technology to your advantage- electronic health records and billing systems can help keep track of patients and their billing information.
Communicate with your team- clear communication is key to avoiding mistakes and misunderstandings. Train your staff on billing and coding procedures. Review your policies regularly to make sure they are still effective and efficient.
Pre-Analytic Phase
Various players often manage the preanalytic phase of the revenue cycle. This guide provides an overview of the preanalytic stage and offers tips for optimizing laboratory revenue cycle management.
The specimens are collected and transported to the Laboratory for testing. This phase is critically important, as improper specimen collection and handling can lead to inaccurate test results.
It is essential to ensure that specimens are collected and transported according to protocols. The laboratory staff is in specimen collection and handling.
Analytics Phase
The analytics phase of RCM is critical to the success of the entire process. In this phase, data is gathered and analyzed to identify opportunities for improvement. The data help inform decision-makers about where to focus their efforts.
Various software solutions are available to help with the analytics phase of RCM. These solutions offer a variety of features, such as:
- Data Visualization
- Reporting
- Data Analysis Tools
Choosing the right solution for your Laboratory is a critical part of the process. The analytics phase of RCM can seem overwhelming, but with the right tools and resources, it can be an essential part of your Laboratory’s success.
Post-Analytic Phase
The post-analytic phase of the revenue cycle begins after the patient has been discharged from the facility. During this phase, the Laboratory will generate patient bills and submit them to the insurance company for reimbursement.
The insurance company will then process the claim and issue a payment to the Laboratory. The Laboratory will then apply the amount to the patient’s account and send a statement to the patient for any remaining balance.
Billing and Collections
In any business, it is essential to ensure that the laboratory billing and collections run smoothly. Laboratories can be complex businesses with many different types of procedures and tests being performed. It is crucial to have an RCM system that can keep track of all of this activity and accurately bill for it.
Make sure all the correct information is collected from patients upfront. Ensure that billing is accurate and timely. Be persistent in collections.
Often, laboratories can be out-of-network with insurance companies, making billing and collections more difficult. However, if the Laboratory is strategic in its billing and collections efforts, it can still be successful. If you want more information about it, click for laboratory medical billing.
Revenue Cycle Management
The bottom line is that revenue management for laboratories is vital for maintaining a healthy bottom line. Without proper management, laboratories can hemorrhage money and go out of business. This guide provides laboratories with the tools they need to manage their revenue cycle properly.
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