Why Is It Important To Understand Laboratory Medical Billing?

Aug 17

A medical lab sees more patients than an urgent care facility or a physician’s office. This implies that medical lab staff usually stay on their toes to handle the patients' needs. Patients visit a lab to get tested or screened. The staff of the lab has very different tasks from the tasks of other medical practices. Instead of doctors and nurses, a lab staff includes phlebotomists and other professionals who take samples and conduct different analyses. The lab staff, therefore, has no time to take care of the laboratory medical billing.

Most laboratories computerize most of their tasks to streamline all their processes. Computerizing or outsourcing some services, such as medical billing reporting, helps lab staff to work quickly and efficiently. Outsourcing from a good medical billing company can help your laboratories financial operation and health. To streamline your lab’s billing process, we recommend contacting U Control Billing.

What is a Laboratory Medical Billing System?

The process of laboratory medical billing is an ongoing one. This cycle runs between the following:

A physician (who prescribes a lab test)
The lab ( that provides the services)
The insurance company or other payer (that compensates for the services provided)

The billing of laboratory services might take days or even months because it needs the interaction of different parties before its resolution. This is why most laboratories tend to have a separate department for handling the medical coding and billing process.

How Does a Laboratory Medical Billing Work?

The laboratory billing process is complex, and it requires the time and dedication of the billing staff. If you are new to the process of laboratory billing, here is an overview:

Eligibility Verification

When the lab staff schedule an appointment, the billing staff checks the patient’s insurance eligibility to ensure that there is no billing surprise after the testing!

Tracking Claims

Laboratory medical billers keep track of patient claims in real-time. In case of any denied claims, the billers edit the errors and resubmit them so that the lab revenue keeps coming faster.

Medical billing reporting

Another task of medical coders and billers is to report everything accurately. From codes to documentation, everything must be reported accurately. Medical billers must accurately report weekly, monthly, quarterly, and annual meetings. Outsourcing medical billing reporting will handle all your financial data with ease.

Tracking Data

In laboratory medical billing, keeping track of your lab data is very important. Many medical billing companies provide or use a single solution that integrates with other systems of the facility to keep track of everything.

Why Does Laboratory Need a Medical Billing Service?

The medical billing of clinical labs is complex and requires proper time and concentration. In the case of negligence, the lab may face claim denials and rejections. These denied or inaccurate claims result in a time-consuming and costly submission and resubmission. In addition to that, as the lab staff already has too much on their plate, it is hard for them to stay up-to-date with constantly changing coding regulations and guidelines. Because of these rapid changes, laboratory medical billing has become complex. Even the most minimalistic type of error causes claim denials. This is the reason that managing laboratory billing in-house has become a challenge. To bring efficiency and accuracy to the billing process, laboratories now tend to outsource medical billing services.

Reasons to Outsource Laboratory Medical Billing

Outsourcing medical billing services help the laboratory staff to focus on what is more important. The medical coders and billers ensure that the revenue of the laboratory remains intact. If you want to avoid claim denials and rejections, partnering with a laboratory billing company can help! Here are some other benefits of outsourcing:

Reduced operating costs and improved cash flow

If you have an in-house staff to manage the laboratory medical billing, you would have to bear software fees, training costs, employee salary, and equipment costs. Your laboratory must keep a significant amount aside to bear the overhead costs. On the other hand, when laboratory medical billing services are outsourced from a third party, your lab can reduce operating costs and increase cash flow.

Automatic verification

Another reason behind claim rejection and denial is improper verification of insurance eligibility. An in-house staff usually does not have the time to verify medical necessity, coverage, or other claims information. Whereas outsourcing these services ensures the criteria of eligibility are met. Also, by automating the verification process, medical billing firms reduce the time utilized on such tasks. This way, your lab’s staff can save time and effort and focus more on their daily tasks.

No billing and coding errors

Most claims are denied, delayed and rejected just because of medical billing and coding errors. According to studies, about 80% of medical claims have some sort of error. But when a laboratory decides to outsource from a medical billing firm that uses good billing software can help to reduce the instances of submission claims that have coding and billing errors. In this way, you can get rid of delayed payments. Moreover, medical billing and coding accuracy will also help improve your lab’s revenue cycle.

Fast processing and payment of claims

As medical billing companies usually automate most of the medical billing and coding processes, processing and payment of claims get quicker. Laboratory medical billing service provider ensures that the processing of claims gets fast. This happens because their expert coders file a claim that is flawless and results in fast payments.

Let Us Wrap Up!

Unlike other practices, laboratories' medical billing and coding process are very complex, time-consuming and ever-changing. When a lab decides to outsource, it can get an optimized billing process to maximize reimbursements and improve cash flow. If you are one of those laboratories that do not have the right staff, time or resources to streamline the billing process, outsourcing laboratory medical billing services from U Control Billing can be your best option. They will care for your billing process and improve your lab’s performance and revenue!