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Effective Clinical Lab Billing Solutions for Optimal Results
< 30
Days in AR
10-15%
Revenue Increase
97%
First Pass Ratio
96%
Collection Ratios
98%
Clean Claims Rate
Overview of Clinical Lab Billing Services
Running a clinical lab while managing the medical billing process on your own is not an easy feat. Clinical and reference labs encounter multiple challenges while managing their billing and payment cycles.
Clinical lab billing is a complex process that requires interactions between the lab, pathology group, and the payer. After running the prescribed tests, the lab must assign diagnostic and procedure codes to indicate which services were performed. They must handle claim submission and oversee the collection process, including follow-ups for timely payments.
MediBillMD offers professional clinical lab billing services to help you stay on top of your competition:
- Pre-test eligibility verification
- Claim creation and submission via clearinghouse
- Claim follow-up, rework, and resubmission
- Real-Time claim tracking
- Denial management
- Patient-friendly statements
- Automated EOB reconciliations
Common Challenges in Clinical LabMedical Billing
As a clinical lab, you must realize the importance of efficient payment processes and invoicing. But are you still struggling to optimize your clinical lab billing processes? The common challenges dragging your lab down can be one or all of the following:
High Claim Denial Rate
Clinical labs face a challenge with claim denials, which is made even worse by the varying communication requirements of different payers.
Claim Denial and Rejection
Claim denials can occur for many reasons, including inadequate information, erroneous patient information, or a lack of pre-authorization. Understanding the causes for denials and swiftly correcting them is critical to preventing revenue loss
Lack of Patient Awareness
Medical billing can be confusing for patients, who may not know if they need a referral or why their coverage has changed. This makes it challenging for labs to keep patients informed about their billing.
Inaccurate Coding
It is one of the most prevalent issues in medical billing processes. Incorrect or over-coding not only results in claim denial but also leads to heavy penalties and compromises your practice's reputation.
Inaccurate or Incomplete Patient Data
It is the most common reason for a payer to reject a claim. The reasons for such claim denials and rejections vary from missing required fields to spelling errors.
Multiple Claims Filing
Most laboratories find it unpleasant to file repeated claims, especially if they offer specialty healthcare testing services. Since no tools are available for generating multiple claims at once, they might end up submitting each claim separately. As a result, the staff feels exhausted and more involved in doing the documentation.
Inadequate Supporting Documentation
Insurance companies require supporting documentation to settle claims by laboratories. They will not think twice before denying a claim if you fail to submit the required details.
Payment-Associated Issues
Billing challenges extend beyond denials. Clinical laboratories must also navigate other payment-related issues, including denied pre-authorization, delayed payments, and pricing disputes.
Outsource Clinical Lab Billing Services to MediBillMD
Healthcare labs often face challenges in managing their revenue cycle and complying with billing regulations, which can be costly and overwhelming.
However, when you outsource your clinical lab billing to MediBillMD, you get access to certified coders and billing specialists who are well-versed and experienced in providing clinical medical billing services. Some other benefits are listed below:
- Increased lab cash flow with streamlined operational processes.
- Reduced billing and coding errors.
- A dedicated team of certified coders and clinical lab billing specialists who are constantly upgrading their skills and knowledge with ever-evolving regulations.
- A team of clinical lab billing professionals will process claims faster than your in-house billing team who are often tasked with other responsibilities.
- Enjoy automated benefit and insurance eligibility verification.
- Efficient denial management and resolution.
Get In Touch With Our Clinical LabBilling Experts
FAQs
Our success is measured in numbers. By partnering with MediBillMD for your clinical lab billing needs, you get the assurance of 98% clean claim submissions, a 97% first-pass ratio, and a 96% payment collection rate. We can increase your clinical lab’s revenue by up to 15% by relentlessly chasing unpaid claims. With a team of certified coders and billing experts, we transform the financial performance of your facility within months.
We only take a small credit for your achievements. Our clinical lab billing services cost 2-5% of your total monthly collections. You may contact our representatives for an exact quote.
Keeping up with the ever-changing regulations and ensuring compliance are the biggest hurdles in clinical lab billing. Healthcare providers and their team of medical coders and billers must stay abreast of the revisions in coding guidelines, payer policies, and government rules and regulations to submit complete and accurate claims on time and secure maximum reimbursements.
