Laboratories are unique parts of the medical establishments because they appear in several sizes and iterations. The findings of such facilities make up the largest percentage of the electronic health record of patients even if they only account for a small percentage of the total revenue of a hospital. 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. The laboratory information system and procedural equipment is focused on by the primary lab workers only when this separation exist. On top of that, because they are not involved with other tasks such as billing and revenue processing, they can provide precise, accurate results and also continue engaging patients and physicians.
Laboratory medical billing should not only be provided by the physician’s office or hospital but also the medical lab staffs should be involved. A set of current procedural terminology is used to bill all labs, and this makes the work or lab billing to be complex. 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. Lab staffs are assigned a diagnosis code when they finish analyzing the specimen. One of the two separate coding indices used by medical or insurance companies is used to assign this type of code. Insurance companies can be helped to decide whether to pay the claim or not by those codes because they have the necessary information. When the codes are determined by the insurance companies, the lab collection and revenue cycle management phase begins. Labs bills insurance companies using a certain claim file that is submitted electronically.