Changes Facing Laboratories Today
October 5, 2022
Claire Catanach, Marketing Coordinator
The healthcare industry, including the clinical laboratory, is tackling a multitude of challenges in today’s demanding environment. The pandemic, and now inflation and wage pressures, have exacerbated a lab’s ability to operate efficiently and remain profitable. These challenges include relying on antiquated information systems for revenue collection; coupled with the need to cut costs due to inflationary pressures and legislation to decrease reimbursements.
Now more than ever, a lab must operate efficiently and optimize reimbursement. One of the ways to overcome these challenges is through automation.
Use Automation Technology to Manage the Revenue Billing Cycle
Most lab billing departments use staff to manually manage some of the revenue billing cycle processes. The margins for reimbursement of claims are not high and with the Protecting Access to Medicare Act (PAMA) and other Federal Government efforts, it’s critical for labs to reduce costs. Below are ways for a lab to run more efficiently:
• Integrate automated eligibility verification and insurance discovery responses directly to claims.
• Identify and implement payer specific pre-billing rules and automate when possible.
• Employ robotic process automation to perform repetitive tasks and free up existing staff to work the more complex claims.
• Improve registration data by identifying missing billing information and educating registration teams and ordering providers.
• Prioritize claims with the maximum cash return to streamline staff workflow.
• Be adaptable to ever-changing payer regulations.
Lessen the Burden on the IT Staff
Just as critical are the IT staff needed to manage and support the systems and platforms that interface with providers, hospitals, and other clinical clients. Today, most labs use an expensive point-to-point, hub and spoke architecture integration system. Each interface is custom coded with its own parameters and nomenclature. In addition, other portals are used to create data bases, which require additional support. For an already overtaxed IT department, the costs continue to grow, and additional vendor support is needed. Below are ways to for the IT Department to better manage the lab’s infrastructure:
• Identify features of existing applications that can be applied, re-configured, and re-worked to overcome staffing shortages.
• Explore existing workflows and applications to find efficiencies and opportunities.
• Reduce costs by investing in a seamless interoperability system that reduces the number of interfaces, point-to-point connections, and gives the lab the ability to participate in patient care with actionable information to its clients.