Source of Truth - Info Series: Five Steps to More Profitable and Efficient Laboratory Operations
November 20, 2023
Recognize RCM is NOT a Back-End Process
Laboratory Revenue Cycle Management (RCM) has traditionally been viewed as a “back-end” process. This outdated view is changing because accurate information needed for a smooth and productive billing workflow can now be interwoven throughout the workflow design of certain software platforms.
It’s best to start the revenue cycle process at the order level, allowing verification and scrubbing components to be shared by both the LIS and RCM modules. Real-time patient/payer data verification seamlessly integrated into one platform prevents rejections and denials and ensures the workflow process is both seamless and able to be easily edited. This live queue-facilitated workflow greatly increases accuracy and throughput efficiency.
Integrate Data to a SINGLE Source Platform
Nationwide, an estimated 35% of claim denials are caused by inaccurate or missing data, which is primarily due to the human error component and time-consuming nature of manual claim processing.
Standalone RCM systems substantially contribute to high denial rates and revenue loss. When LIS & RCM modules operate as separate silos, even if interfaced, the full capabilities of each cannot be achieved due to lack of consistency, transparency, and integrity of data.
A single fully integrated platform that shares a common database and software infrastructure ensures proper interchange of laboratory data, greatly improving workflow integrity, accuracy, and processing.
Implement Rule-Based Automation
Manual processes often lead to user error and missing or inaccurate data. Furthermore, cumbersome and complex CPT and ICD coding typically bring on subsequent error-prone entries. Collectively, this greatly increases inaccuracies that lead to rejections and denials.
Rule-based automation ensures verified demographics, accurate CPT/ICD coding, proper TC/PC and other modifiers for assignment and splitting, and regulatory institution compliance (PTP, MUE, LCD, NCD ). This provides a transparent and customizable workflow and statement generation, which facilitates accurate data integration throughout the entire workflow.
Maintain Constant Full Visibility of Your Lab Operations & Finances
Even when revenue and net collections are robust, the industry is constantly in flux. So it is crucial that one is fully aware (at the touch of a button) at all times of both high and low margin procedures, operational gaps, and department efficiencies or lack thereof.
If the goal is to increase your lab’s clean claim pass-through rate, you should look for a robust system that tracks all data and lab operations and gives you the ability to create customizable reports and dashboard templates that can easily be used to measure efficiency and workflows.
Remain Forward Thinking and Able to Pivot Given Unforeseen Industry Changes
Too often, laboratories become set in their ways when the niche focus is on profitability, and not on investment in infrastructure improvements. This gets overlooked because it’s deemed “not needed” for the lab’s current operations processing. This is primarily due to investment and current return on that investment, and the high cost of traditional, siloed, hard infrastructure improvements.
A way to counter this potential stalemate when the tides change is to invest in a pliable, customizable, and ever-expanding software platform. It’s a smart choice that will pay huge dividends down the road.
Look for software that has no huge cost of entry and rather one that’s based on a true partnership model with no added future costs. One with a sharing of costs and a tailored metrics model.
With this model, you’re never hit down the road with unforeseen costs, and you have a future-proof operation at the onset, anchored by an enterprise level RCM software platform that’s ready to pivot and expand at any time in any landscape.
To learn more about how LigoLab can increase your clean claim pass-through rate and improve your overall laboratory workflow operations through advanced, highly customizable automation, connect with a LigoLab Specialist below.