Laboratories are unique parts of the medical establishments because they appear in several sizes and iterations. Even though such facilities only account a small percentage of the total revenue of a hospital, their findings make up the largest percentage of the electronic health record of patients. More to that, such facilities formulates the most critical parts of the healthcare decisions, which makes them necessary. Because of that reason, if you want to improve the patient outcomes, you need to pay careful attention to the revenue produced by the labs. The working cash flow available also needs to be accounted for by those who would like to improve technology, staffing, and other lab resources.
The billing and revenue process do not include the primary lab workers even if one of the critical points of focus for the medical laboratory is revenue. In many cases, you find that most labs house their billing facilities separately from other portions of labs because lab employees are not included in the billing process. When this separation exists, primary lab workers focus only on the laboratory information system and procedural equipment. More to that, they can provide precise, accurate results and also continue engaging patients and physicians because they are not involved with other tasks such as billing and revenue processing.
Laboratory medical billing should not only be provided by the physician’s office or hospital but also the medical lab staffs should be involved. Because all labs are billed through a set of current procedural terminology it makes the work of lab billing to be difficult. Medical laboratory billing is a cycle process because it begins with interactions with a doctor, lab order, insurance company, and the back to doctor. Because this billing cycle needs multiple interactions between parties involved, it can take several days, weeks, or even months. Labs have a completely separate coding and billing department that navigates the billing cycle and that’s why the process takes a lot of time.
When you are ordered by a physician via a specific code to go to such facilities, that’s when the billing cycle begins. When the lab staffs finish analyzing the specimen, they are assigned a diagnosis code. This type of code is assigned according to one of the two separate coding indices used by medical or insurance companies. Those codes are important because they have the necessary information that can help insurance companies to decide whether to pay the claim or not. When the codes are determined by the insurance companies, the lab collection and revenue cycle management phase begins. A certain file that is submitted electronically is used by labs to bill insurance companies.