Laboratories are unique parts of the medical establishments because they appear in several sizes and iterations. Even though such facilities only account a small percentage of the total revenue of a hospital, their findings make up the largest percentage of the electronic health record of patients. On top of that, the most critical parts of the healthcare decisions are formulated by them and that’s why they are necessary. The revenue produced by labs needs to be taken care of because of the reason I mentioned above because it can improve the patient outcomes. The working cash flow available also needs to be accounted for by those who would like to 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. Because lab employees are not included in the billing process, in many cases, you find that most labs house their billing facilities separately from other portions of labs. When this separation exists, primary lab workers focus only on the laboratory information system and procedural equipment. In addition to that, they are not involved in other tasks such as billing and revenue processing, and because of that reason, precise and accurate results can be provided by them as they continue to interact with patients and doctors.
Laboratory medical billing should not only be provided by the physician’s office or hospital but also the medical lab staffs should be involved. Because all labs are billed through a set of current procedural terminology it makes the work of lab billing to be difficult. Because medical laboratory billing begins with interactions with a doctor, lab order, insurance company, and then back to the doctor, it is regarded as a cycle process. 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. Labs have a completely separate coding and billing department that navigates the billing cycle 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. Lab staffs are assigned a diagnosis code when they finish analyzing the specimen. One of the two separate coding indices used by medical or insurance companies is used to assign this type of code. Those codes have the necessary information that can help insurance companies to decide whether to pay the claim or not, and that’s why they are important. When the codes are determined by the insurance companies, the lab collection and revenue cycle management phase begins. Insurance companies are billed by labs using a certain claim file that is submitted electronically.