The current evolution in the healthcare industry particularly in the toxicology laboratories is somehow creating uncertainty due to complex payment systems. So, in order to thrive during these challenging circumstances, toxicology labs must outsource the best toxicology billing services for financial prosperity.
Moreover, current changes and inconsistencies in policy are constraining downward pressure on reimbursement rates, increasing employee costs, and the expenses related to buying and keeping up the technology needs.
So, due to these pressures, toxicology lab professionals are taking steps to figure out which choice, dealing with their billing in-house or out-source, will streamline their cash flow.
Evolution of toxicology labs
Only a couple of years back, the clinical toxicology laboratory space was filled up with startup labs, managed by people with a lack of experience in the field. Their billing and payment collections processes were lacking as well.
Moreover, Their choice of a lab medical billing and Revenue Cycle Management (RCM) vendor was based upon limited internet searches of local medical billing companies.
Another issue, however, was that most of these organizations were physician billing companies with practically zero foundation or experience with regards to laboratory billing (or explicitly, toxicology billing services).
They had restricted specialized skills (needed for making advanced electronic work processes) to deal with the high volumes of extremely specific claims produced by such labs.
As these organizations began to develop alongside the business, they were able to secure the business of some of the larger laboratories.
With the drastic change in time, circumstances are different now. While the interest for toxicology testing has expanded, reimbursements for such tests have diminished definitely.
Therefore, in order to keep pace with current changes, the trend of outsourcing billing services increased.
Things to consider before outsourcing
Anyway, what should labs see while assessing their current or planned billing accomplices? The following are six significant considerations.
- Services offered
Is the billing company exceptionally had practical experience in the toxicology lab environment?
This is likely the most significant part of picking a suitable resource for lab billing and coding. If the services you need aren’t offered, then why you are paying for such services?
At the very least, your toxicology billing services should give ensured turnaround times to complete coding, submitting claims, and following up claims that have been postponed or denied.
You should also search out firms that have involvement in your provider strength so they are very much aware of particulars for billing and coding for your practice.
You may also want to discover what sorts of additional items they offer. A few firms are eager to provide additional advisory, monitoring, and management services related to medical billing and coding.
- Direct interfaces with LIS
Does the lab billing company have direct interfaces with your laboratory information system (LIS)?
A laboratory information system (LIS) is a computer-based information management system made explicitly for labs. A LIS is utilized to help work processes in the lab—just as the archive to store lab information—while supporting the lab’s mission.
The objective is to convey right and complete data to lab staff, directors, and clients as productively as possible. Patient data, testing results, must stream electronically from the LIS to the billing software system. Can’t someone just key that information into the billing system manually? Absolutely – but then there is less time to follow-up with insurance payors.
- knowledge about insurance specifics
While regarding the matter of insurance specifics, do they know precisely which payors need which code set for toxicology billing?
There are various code sets and only one out of every odd payor acknowledges similar codes – and some have explicit prerequisites for such codes.
If the providers of toxicology billing services have no idea about it, then you know who is going to pay the price.
As a lab owner, you’re constantly worried about the primary concern, so you have to deliberately assess the financial advantages of outsourcing.
What sum is normal by them for their offered types of assistance? The ideal way to move toward outsourcing is that a particular rate is chosen. This is the level of all net gathered receipts that they get.
It is preferred that an organization charges around six percent to ten percent if this way is adopted. Any rate greater than this would be considered as excessively high.
It is also imperative to ensure that any extra charges are explained. This can incorporate the charges of a startup, termination, information change, and patient collections. Along with these, another significant factor is the average time for receivable.
It is viewed as better to pick toxicology billing services that have an average time of 14 to 30 days. This factor is additionally reliant on payer rules.
Even when you outsource to experts, you still need to know what’s going on with your medical claims.
A reputable and reliable lab billing company should give you regular reports that show what they’ve been doing for your benefit and where you stand with claims. You don’t really need to micromanage, however, you do need to at least oversee billing to ensure that it is being taken care of in an ideal and productive way.
Patient privacy is absolutely critical to your practice, not only because you’re maintaining a business and your customers are confiding in you with their confidential information.
But also you need to conform to federal and state privacy laws, just as HIPAA guidelines. You should find a trustworthy provider of lab billing services, one that takes security as seriously as you.
Take Action Now
Toxicology lab billing is a highly complex process that reliably experiences unpredictable changes frequently. So, take action now to outsource toxicology billing services to optimize your revenue collection and generation.
Lab Billings is a well-reputed revenue cycle management company in the United States. We provide the best possible solutions for your practice growth and financial stability. For further information, visit our website: https://laboratorybillings.com/toxicology-lab-billing/