The Laboratory Accounts Receivable (AR) system is specially designed to operate in this challenging environment from accurate registration capture to management of the billing and follow-up process with automated workflows that identifies priority next steps.
Scenario: Ongoing Failed Registration Process
The hospital laboratory outreach program has always struggled with an ongoing failed registration process due to multiple ordering locations (the referring physician office) outside the control of the laboratory and billing departments.
- The AR system contains all the tools necessary to achieve a successful registration packaged and deployable to all ordering locations including the outside referring physician location and patient service center. Insurance eligibility checking, pre-authorization, document capture, and a workflow routing system for bi-directional communication. Imagine a registration process containing all the highly sought-after billing elements and order generation occurring at the same time.
- The AR system also serves as a communication tool post registration for any follow-up with referring clients using a message workflow routing system - no more faxing, emailing, calling, or mailing the physician office is required.
Scenario: Identifying Prioritized Workflow Assignment
Hospital billing teams struggle with volume heavy and process heavy work. Management is constantly challenged with identifying and prioritizing the workload.
Priority processing will help to alleviate the burden and guesswork of prioritizing the next-best claim to work so your teams can do more
- Most billing departments have job functions or special projects that would benefit with workflow assignment with priority sorting. Registration, insurance eligibility checking, pre-authorization verification, billing, timely filing, appeals, rejections, denials, aging AR, small dollar balances, and refunds.
- Intelligent work distribution automatically assigns work based on your organization’s priorities and the skill set of available team members. This transfers the burden of determining the next best claim to file based on priority guidelines.
Scenario: Struggling to Manage Laboratory Outreach using Tools Designed for Hospital Billing
Hospital laboratory outreach programs struggle with the complexities of the laboratory revenue cycle managed using the Hospital Information System (HIS).
The AR system is configured for this challenging environment, available in two configurations:
- Standalone fully functional AR system - allows the hospital to carve out the laboratory outreach business to be managed on a dedicated system designed for this business model.
- Front-end system for registration capture and ongoing bi-directional communication with referring ordering clients, patient service centers which dramatically improves information capture on behalf of the HIS.
Scenario: Challenging Multiple Billing Scenarios
The hospital laboratory outreach program presents challenging billing scenarios: UB04/1500 claim types, physician client billing, nursing home client billing, professional/technical component for pathology, and reference lab send-out testing.
- The AR software has functionality dedicated to each of these process that reduces labor and improves billing and collection efficiency.
Scenario: Ongoing Monitoring of Referring Client Behavior
Monitoring the quantity and quality of the orders and the financial impact of the referring physician clients is highly desirable however falls behind other competing priorities.
- The AR system generates score cards capturing data related to ordering patterns, physician specialty, profitability, payer mix, volume up/down, and other multiple factors.
- The ability to track related business income (not taxed) vs. unrelated business income (taxed) that comes from your referral physician clients.