How To Outsource Laboratory Billing Services? Step By Step Guide

With the sudden growth of medical billing companies, more and more healthcare lab leaders prefer to outsource laboratory billing services to a reliable billing agency in the USA. It helps laboratory technicians connect with medical billing experts without going through the time-taking procedure of hiring an individual employee for their medical billing department. In this way, they make sure that their medical claims are prepared and filed by lab billing professionals from remote locations accurately at a more easily affordable price. 

Laboratories are a unique part of the medical industry, appearing in different sizes and specialties. Although, most healthcare labs are associated with hospitals they only contribute 3 to 5% to the hospital’s total revenue. However, the diagnostic procedures performed by healthcare labs make up 70 to 80% of a patient’s electronic health record (EHR) and they constitute the most critical component of medical treatment decisions. 

According to a recent study conducted by CDC, almost 70% of medical decisions depend upon lab test results. Therefore, it is the time when healthcare labs should be empowered financially so they can streamline their business operations, deploy more advanced equipment and contribute to the healthcare industry more significantly. 

It requires specialized knowledge to understand the healthcare lab procedures, billing requirements, and coding expertise. There are only a few students in the USA who get proper training in specialized laboratory medical billing services. Therefore, practitioners tend to hire inexperienced medical billers and train them for lab billing and coding services. It could be a time-consuming and labor-intensive task. Moreover, it is nearly impossible for small-sized labs to invest a huge capital amount in the constant training and education of their employees. 

In this case, outsourcing laboratory billing services can rescue you from billing complications. However, due to strict data security policies and HIPAA protocols, you can’t hand over your patient-protected health information (PHI) to any third party. You have to make a well-informed decision and consider essential points to analyze the trust factor of a laboratory medical billing company

I have listed down a step-by-step guide on how to prepare your healthcare lab to outsource lab billing services to a reliable medical billing company; 

Step 1:  Ensure Your Laboratory Meets CLIA License and Credentials Requirements

Before starting your search for a reliable laboratory medical billing company, you should make sure that your healthcare lab has a current CLIA (Clinical Laboratory Improvement Amendments) license. Also, you should make sure that your healthcare lab meets the credentialing requirements of the insurance companies. 

This is a pre-outsourcing lab billing services step which is very critical for the rest of your decisions. If you don’t have the credentials or they’re outdated then you should consult with a lab billing company that also offers credentialing services e.g. CureCloudMD is a US-based lab billing company that also offers credentialing and provider enrollment services. It helps you complete the month-long credentialing and enrollment procedures without taking the headache. 

Step 2: Deploy A Reliable LIS (Laboratory Information System)

LIS system enables lab practitioners to share their lab data with the medical billing software with an electronic data interface. If your organization uses a LIS system then you should establish connectivity of the LIS system with the medical billing software of the lab billing company. 

Your LIS will help you enter, save and monitor patient demographics and manage the details of lab tests performed by your lab professionals. Also, it helps you get visibility for unpaid tests and diagnostic procedures. 

Therefore, if you haven’t used any LIS system beforehand then you should take a lead now. Of course, you have to deploy the latest LIS software system that is compliant with the current security protocols to safeguard your patients’ sensitive data. It will also help you take better control over your patients’ data when you outsource laboratory billing services

Step 3: Analyze The Experience Of The Laboratory Billing Company

I know, it would be difficult for you to get full visibility of the client acquisition and retention rate of a medical billing company because they don’t disclose their confidential data. However, you have a right to inquire about the client’s feedback and years of experience in medical billing and coding from the medical billing company. 

You can ask for the billing portfolio of their representative to make a well-informed decision. Also, you can check out the client’s reviews from the Google review section, their social media profiles, and their website. Talk with their medical billers and coders to take their interviews and analyze their expertise in laboratory billing services. 

Step 4: Make Sure Their Staff Size Is Sufficient For Your Practice

Prepare a general report of your past experience and analyze the maximum number of medical claims filed by your practice. Then inquire the medical billing company if they have sufficient staff to handle this amount of claims regularly. 

Usually, a medical billing company increases its resources according to its clients’ needs but you have to be sure before making a final decision. 

Step 5: Establish a Point of Contact to Lead Communications

Don’t hesitate to communicate your requirements clearly with the laboratory billing company before signing a contract. Clear communication always helps you make the best decisions for your business. You can also make a point of contact to lead communication between your staff and the outsourced medical billing team. 

It means you can assign this task to anyone from your office team to coordinate with the outsourced medical billing team including their billing manager and staff director. Therefore timely communication with your internal and external team can you troubleshoot workflow problems before they arise during the execution of business operations. 

Also, you have to ask the medical billing company how will they integrate their medical billing software solutions with your LIS system. You can also guide them about your restrictions on data sharing and protection in order to stay safe from legal repercussions. 

Involve your internal office team during this procedure and guide them on how would they can adjust an external medical billing team with their regular workflow. There will be a lot of details to discuss with your team from determining where orders are placed and how results from tests wind up in the patient’s records in the EHR system. 

Step 6: Compare The Charges Of Different Medical Billing Companies

Discuss with your finance team how much could should you invest to outsource laboratory medical billing services beforehand. Then compare the charges of different medical billing companies to find the best lab billing company according to your budgetary constraints. But remember that different medical billing companies charge in different ways. Typically, lab billing companies in the US charge in the 3 following ways; 

  1. Percentage per revenue collected by the medical billing company on your behalf after submitting your claims. 
  2. Charge per hour required to run your medical billing cycle. 
  3. Percentage per claim filed by the medical billing company. 

Usually, the first option works best for most healthcare labs. Because in this way a medical billing company will get paid only when you get your reimbursements from insurance companies. So it will create mutual success opportunities for your practice and your billing partner. 

Looking for a reliable and well-secured laboratory billing company that offers the most cost-effective lab billing services? CureCloudMD is a well-established medical billing company that has been helping several healthcare labs for more than a decade. They also offer a free medical billing audit before onboarding their clients so they can create their own custom-tailored package of healthcare revenue cycle management outsourcing services. 

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