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. In addition to that, such facilities are necessary because they formulate the most critical parts of the healthcare decisions. 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.
The primary lab workers are not often involved in billing and revenue process even though revenue is a critical point of focus for medical laboratory. 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 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. Multiple interactions between parties involved are needed in the billing cycle, which on the other hand, makes the process to last for several days, weeks, or even months. The process takes a lot of time because labs have a completely separate coding and billing department that navigates the billing cycle.
If you are ordered to go to such facilities by a physician through a specific code, the lab billing cycle will begin from there. When the specimen is analyzed completely by the lab staffs, a diagnosis code is assigned to them. This type of code is assigned according to one of the two separate coding indices used by medical or insurance companies. 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.