The determination to outsource your billing operations can be stressful and complex, influencing staff, patient flow, and your bottom line. In addition, lab billing has always demanded a specific collection of talents and proficiency. Still, with substantial bottom-line intimidation from shrinking margins and evolving payment configurations, it has become necessary to investigate the benefits of simplifying your reimbursement approach.
If you currently use a third-party associate in some element of the healthcare revenue lifecycle, now might be the moment to widen their coverage and analyze the technological aid they offer. An external partner's function should be automated and streamlined while leveraging the advantages of artificial intelligence and machine learning.
Beyond supplying patient care insights through testing assistance, the healthcare revenue lifecycle is arguably the most critical activity in every lab. Unfortunately, understanding the billing complexities of laboratories is complicated, and remaining current is a continuous challenge. Here are three functional complications that can be positively managed when partnering with an external vendor:
When you partner with an external group, you purchase the talents and know-how of a specialized team committed to supplying you with the highest rate of billing assistance. You can anticipate that they have the latest facts and training in their area of expertise and in-depth knowledge of every insurance carrier and their latest updates and transformations.
It is always challenging to anticipate resource and staffing needs when company levels evolve, but with an outsourced resolution, you no longer have that problem. It will be up to the external organization to scale up or down based on your needs. The savings and efficiencies are handed to you without the headache of daily human resources problems.
According to one AMA survey, 92% of doctors declare that the prior authorization system generates delays in patient care and sometimes leads to care abandonment. Additionally, once a commercial insurance carrier denies a request, it can create delays from two days to two months. Therefore, piercing through the prior authorization process, then identifying and repairing problems causes vast benefits further down the reimbursement line by decreasing denials and enhancing patient relations.
An external vendor is compensated on collected payments and highly motivated to submit pristine claims and promptly gather your outstanding payments. But, equally, they are interested in quickly investigating and resubmitting outlier claims to boost your bottom line and their own.
Ultimately, the objective is to seize the highest revenue for the assistance provided within the contracts between your lab and insurance carriers. By using a third-party associate, you acquire the following:
By partnering with a third party, you acquire expertise and mastery that enhance the promptness of your reimbursement and professional contract administration and analytics to run your business better. However, the genuine value to you and your lab is the power to concentrate on what you accomplish best—patient care!