Laboratory Billing Services

How To Outsource Laboratory Billing Services – A Practical Guide?

Last updated on December 21st, 2022 at 02:51 pm

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Laboratories have a very unique set of requirements than any other medical establishment. Therefore, laboratories should pay more attention to revenue cycle management. In order to acquire professional assistance, providers should outsource laboratory billing services. It will help them to improve cash flow, adopt innovative technology, acquire a dedicated workforce and enhance patient outcomes.

A laboratory medical billing company helps you require a program built around the unique circumstances provided by a medical lab. But it is difficult to find the best medical billing vendor today. Therefore, practitioners should consider the important factors that are the essence of the best medical billing company.

You can make a qualified decision and outsource laboratory billing services in the following ways;

1. Do Proper Industry Research:

If you are struggling with bad debt accrual, aging account receivables and excessive claim denials then it is wise to outsource lab billing services. Before trusting a lab billing company, you should do proper industry research. It is not a daunting task if you are considering it like that. Yes! You can just find a little time to browse over the internet. Search for billing vendors and analyze the following things;

  • Reviews
  • Client’s Testimonials.
  • Feedback on Social Media.

Thoughts and reviews of the existing clients of the company can help you evaluate the influence of that lab billing service provider. In this way, you can get an idea of the proficiency and scalability of a billing company without compromising your practice.

2. Assess Qualified Staff:

The billing cycle is initiated from the step when a lab billers translate procedures into the standard medical codes. For instance, after analysis of a sample or specimen, it is translated into diagnostic or procedural codes according to one of two separate coding indices that are used by the medical and insurance industry. These codes are essential for the insurance company or other payer as they are responsible to determine whether to pay the claim or not.

Only a well-qualified medical billing staff can understand the unique requirements of the medical lab industry. They must have prior knowledge of the current coding standard. They should comply with real-time changes in the medical coding industry to stay afloat of the industrial standards. Otherwise, if they will fail to provide medical claims with current medical codes then they will end up in excessive revenue loss due to claim denials and rejections.

3. Compliant and Upgraded Medical Coding:

The laboratory billing process comprises two primary sets of codes that are set forth for coding purposes.

  • International Classification of Diseases, (ICD):

It is used to translate the International Statistical Classification of Diseases and Related Health Problems into standard medical codes. The World Health Organization (WHO) is responsible to maintain and classify this set of codes. It is considered as an international diagnostic and epidemiological standard. It provides a framework of diagnostic codes that are used to classify diseases, symptoms, injuries, and other complaints.

  • Current Procedural Technology Code (CPT):

The American Medical Association has introduced CPT codes to translate diagnostic services into standard medical codes. This code set is used to describe all the various medical, surgical and diagnostic services performed by the healthcare practitioners. It is essential to design a set of uniform classifications for use by medical providers, patients, coders, insurance companies and other payers.

Always discuss and analyze the medical billing company has enough knowledgeable staff that is well-versed with the nuances of laboratory billing services. It is essential to ensure that your administrative team has the expertise to comply with regulatory standards and guidelines.

4. Timely Reimbursement:

Once you assess the knowledge of medical coding then the next step is to look forward to the task efficiency of the lab billing company. In most cases, the lab bills the insurance payers or any other payer directly via a learning house, using an ANSI 837 claim file submitted electronically on an electronic data interchange (EDI). Once received, insurance payers use medical claim adjusters or even advice from lab practitioners to ensure medical necessity, patient eligibility and accuracy of documentation.

Therefore, it is essential that you should validate the efficiency and accuracy of medical billing vendors. Make sure that their staff uses reliable billing solutions to ensure accurate information flow.

5. HIPAA Compliance:

Having a discussion about information, make sure that an authentic medical billing company works in compliance with HIPAA protocols. It is necessary to identify areas for future growth. Since it is the only way to ensure that you are sharing information with an authentic entity. On the simplest level of data management, you should verify that overall patient data is kept in safe hands.

6. No Hidden Charges:

Usually, a lab billing company charges healthcare practitioners a fixed percentage from the net revenue they collect on your behalf. Even if they ask you that they will charge a 5 percent from the claims they reimburse from payers for your practice. Due to hidden charges, it will cost you 10 – 15%. Beware of such fraudulent activities and always search for reliable billing companies that are transparent in their charging system.

Unfortunately, dysfunctional laboratory billing procedures can lead to the opposite impact within your medical labs. Therefore, always rely on a trustworthy billing company that keeps their charging protocols transparent with you.

Medcare MSO is a reliable lab medical billing company that has been serving medical practices for more than 12 years. We provide proficient laboratory billing services to healthcare practitioners so they stay afloat of the industry standards.