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. On top of that, the most critical parts of the healthcare decisions are formulated by them and that’s why they are necessary. Because of that reason, you need to pay careful attention to the revenue produced by the labs if you want to improve the patient outcomes. You also need to account the working cash flow available so that you can improve technology, staffing, and other lab resources.
Even though revenue is a critical point of focus for medical laboratory, the primary lab workers are not often involved in billing and revenue process. The billing facilities are housed separately from other portions of labs by many labs in most cases because the billing process does not involve the lab employees. The primary lab workers focus only on the laboratory information system and procedural equipment when this separation exists. 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.
A physician’s office or hospital should not be the only one that provides laboratory medical billing, but also the involvement of medical lab staffs is necessary. Lab billing is a complex task because all labs are billed through a set of current procedural terminology. 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. The billing cycle is navigated by a completely separated coding and billing department, 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. The medical or insurance companies uses one of the two separated coding indices 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 insurance companies determine the codes, the lab collection and revenue cycle management phase begins. Insurance companies are billed by labs using a certain claim file that is submitted electronically.