This type of billing (high volume low dollar) is extremely complex with many disconnected processes that are difficult to manage and often is considered low priority of the hospital billing department due to the level of effort required to chase down missing, incomplete, and inaccurate billing information. In this scenario the low dollar lab claims compete with the high dollar hospital claims for the attention of the billing team.

• Our dedicated laboratory team works with 35 different billing systems we can use yours or our laboratory specific billing software. Our mission is to work with the laboratory department brining our experience and lab specific software to redesign the laboratory revenue cycle to optimize the capture of information for claim submission and improve follow-up from inception of the order to the final posted payment
• Often the registration process occurs outside of the control of the laboratory – we have a proven method to consistently address this
• The laboratory revenue cycle has unique billing scenarios: UB04/1500 claim types, physician client billing, nursing home billing, professional/technical component for pathology, and reference send out testing – all require experience and a proven workflow to manage
• From a revenue cycle perspective: capture of data related to physician ordering patterns, physician office performance score cards, and test level reimbursement tracking is critical to lab management for profitability analyses. This information is obtainable; however it requires blending data from different sources to complete the picture
• Highlight of some of our capabilities and services: supplemental outsourced RCM, full outsourced RCM, special projects as needed, startup staffing until operational, engagement duration fulltime, part time, interim, your billing system or ours, the RCM priority claim workflow software can remain in place for transition to your inhouse team

Laboratories need a billing provider that recognizes the value of quick turn-around-time for billing and reimbursement while maintaining transparency into the finance and operational performance

• Laboratories need an experienced team of specialists that understand the unique needs of the laboratory revenue cycle and what it takes to get paid for what you do
• Reduced laboratory reimbursement requires a billing process that leverages an automated workflow that monitors and improves information capture leveraging rules for priority processing
• From a revenue cycle perspective: capture of data related to ordering patterns, physician office performance score cards, and test level reimbursement tracking is critical to lab management for profitability analyses
• Highlight of some of our capabilities and services: supplemental outsourced RCM, full outsourced RCM, special projects as needed, startup staffing until operational, engagement duration fulltime, part time, interim, your billing system or ours, the RCM priority claim workflow software can remain in place for transition to your inhouse team

This industry is exploding with growth however many challenges confront capture of information and complex billing and reimbursement requirements

• Molecular Dx Laboratories need an experienced team of specialists that understand the unique needs of the Molecular Dx revenue cycle and what is takes to get paid for what you do
• High reimbursement per test necessitates a billing process that is labor intensive with several steps requiring supporting documentation, prior authorization, and correct coding within an aggressive timeframe. Our dedicated experienced team uses automated workflow software that monitors claim level detail, outlines required steps, and identifies missing information based on payer and processing lab guidelines to improve the required information capture ensuring nothing is overlooked or delayed based on priory processing for claim submission and follow-up
• Highlight of some of our capabilities and services: supplemental outsourced RCM, full outsourced RCM, special projects as needed, startup staffing until operational, engagement duration fulltime, part time, interim, your billing system or ours, the RCM priority claim workflow software can remain in place for transition to your inhouse team

Coding and billing services designed for pathology labs, practices, pathology departments of hospitals that require experience in the unique challenges of this specialty.

• Due to the complex nature of pathology billing and coding, the amount of time it takes to complete the required steps can be labor intensive. As a revenue cycle management company, we understand correct billing and getting reimbursed quickly is a mission critical commitment
• We recognize experience in managing the technical and professional component in pathology billing is a must
• We understand pathology services is a highly competitive market and strive as your billing provider to take the necessary steps in the billing and collection process to make sure your client; the referring physician and their patient are satisfied with the billing process
• Highlight of some of our capabilities and services: supplemental outsourced RCM, full outsourced RCM, special projects as needed, startup staffing until operational, engagement duration fulltime, part time, interim, your billing system or ours, the RCM priority claim workflow software can remain in place for transition to your inhouse team

As an experienced revenue cycle management company: we cover multi-specialty physician groups, emergency room, specialty clinics, and rural health clinics. Your organization can depend on us to efficiently collect from patients and payers, keeping you ahead of regulatory requirements, and increase cash flow.

• Whether you are just starting your practice, have multiple specialties, or adding additional providers, we are prepared to support your business
• We leverage data analytics; from KPI monitoring to claims level data to identify trends that lead to better decisions and higher collections
• You need to generate and maintain cashflow – Our team will seamlessly process your claims in the right order that generates the highest cashflow output – All other outsourced billing teams process claims “first-in, first-out.” That is not efficient and does not drive the most cash for you
• Highlight of some of our capabilities and services: supplemental outsourced RCM, full outsourced RCM, special projects as needed, startup staffing until operational, engagement duration fulltime, part time, interim, your billing system or ours, the RCM priority claim workflow software can remain in place for transition to your inhouse team

We are an experienced revenue cycle management company working with hospital-based physician radiology groups and independent imaging centers. As your radiology billing partner, we provide a team of experts in the field of radiology

• Use of imaging equipment and the radiologist’s examination generates two billing components, the technical component (the capturing of the image) and the professional component (the interpretation of the diagnostic results)
• We recognize specialized radiology coding experience is a must to navigate all the regulatory changes and code sets
• Our priority claim workflow software prioritizes claims making sure to reconcile all procedures and services provided have been received, coded, and processed providing a following-up path until final reimbursement is received
• We leverage data analytics from KPI monitoring to claims level data to identify trends that lead to better decisions and higher collections
• Highlight of some of our capabilities and services: supplemental outsourced RCM, full outsourced RCM, special projects as needed, startup staffing until operational, engagement duration fulltime, part time, interim, your billing system or ours, the RCM priority claim workflow software can remain in place for transition to your inhouse team

Hospitals may require a supplemental revenue cycle provider than can assist with the day-to-day operations due to staffing needs, stagnant AR, low-dollar AR, or labor-intensive follow-up efforts required for certain claim types. As an extension to your central business office (CBO) we have experience in a variety of medical specialties deeply familiar with their unique challenges. We can assist in those areas, focus on certain designated areas, or special projects you need assistance with.

• Once assigned areas in need of improvement, our team works with your HIS and claim scrubber leveraging our experience and RCM priority claim workflow software to optimize the capture of information for successful claim submission and improved follow-up through mapped out sequences based on payer and your organizations guidelines
• Hospital laboratory outreach billing – which is “high volume / low dollar in reimbursement” is extremely complex with many disconnected processes that are difficult to manage and often is considered low priority due to the level of effort required to chase down missing, incomplete, and inaccurate billing information. We have additional technology and a specialized team of experts to convert this into cash. In addition to the RCM services, we deploy detailed KPI’s to monitor profitability, workflow, claim line detail, and monitor referring physician financial performance for high performing / low value clients impacting the outreach profitability
• Other areas where we can help are denials follow-up, coding, preauthorization’s, payment posting, and eligibility checking are a sampling of some of our frequently requested services
• Highlight of some of our capabilities and services: supplemental outsourced RCM, full outsourced RCM, special projects as needed, startup staffing until operational, engagement duration fulltime, part time, interim, your billing system or ours, the RCM priority claim workflow software can remain in place for transition to your inhouse team