Billing private and government insurance carriers for payment can be a labor-intensive, time-consuming process. Time means money in laboratory billing, so your office must have adequate protocols and software to handle it effectively. The best protocols and software will ensure that eligibility is confirmed and all pre-authorizations and referrals are in place before billing happens. Unfortunately, some things can impede the submission and payment of laboratory billing.
Providing your billing office with accurate insurance and patient demographic information is crucial. A single missing or incorrect letter or digit in an insurance ID number can greatly slow the billing process, resulting in referring physician or patient tracking to determine the correct ID number, leading to days or weeks of delay in billing your services. To avoid this issue, upload a copy of the patient’s insurance card into your billing software when services are rendered. In addition, to help prevent the misspelling of addresses and names, upload a copy of the patient’s driver’s license or state ID to your billing software.
It is critical to get patients' active medical insurance policy information to bill insurance carriers appropriately. When a patient presents an insurance card they think is active but is not, it can significantly slow the billing process. In addition, if the insurance information provided to you is inaccurate, they are no longer covered y their insurance plan, or there are eligibility issues they have to deal with through their employer, your bottom line will suffer because you cannot submit the bill until you obtain active coverage information.
The ability to quickly and efficiently verify insurance policy eligibility and confirm the network payer status is one of the best features of laboratory billing software. Proactively verifying patient eligibility ensures efficient billing and eliminates the possibility of problems coming up later due to payer denial. Laboratory billing software will evolve a 30-minute call to an insurance company into an online verification that usually takes less than a minute, saving time that you can focus on other resources. This ultimately saves you money too.
There are vast differences in how in and out-of-network claims are processed for payment. For example, many insurance policies offer no coverage for out-of-network services, so it is crucial to have lab billing software capable of managing these denials and tracking them appropriately. In addition, because patients bring in new insurance coverage regularly, it is critical to have the capability to track out of network claims processing versus in-network claims processing for denial and payment trends.
Your revenue can be significantly delayed when denials are not appropriately tracked. For example, when a claim submitted to an insurance carrier for payment is denied pending a patient update on coordination of benefits, you can resolve the issue efficiently by contacting the patient and requesting that they provide their insurer with updated information. Mismanaging these denials leads to unnecessary payment delays. The right laboratory billing software efficiently manages and works these denials for faster payment receipt.
These five things can seriously impede laboratory billing. Contact Hankins Consulting today for laboratory billing solutions. We are here to keep your lab efficient and profitable.