Perhaps an even greater challenge than federal and commercial guidelines, however, is the Merit-Based Incentive Payment System (MIPS), which determines Med Billing payments according to scores in four performance categories: Quality, Cost, Improvement Activities (IA), and Promoting Interoperability (PI). To prevent payment cuts in 2020, and to earn the maximum incentive, pathology labs must report on six Quality measures and up to two IA measures. Accurately billing for each component of pathology procedures is crucial to ensure proper claims adjudication. Proper coding and documentation for surgical consultation services are also significant for accurate claims adjudication.
Perhaps an even greater challenge than federal and commercial guidelines, however, is the Merit-Based Incentive Payment System (MIPS), which determines Med Billing payments according to scores in four performance categories: Quality, Cost, Improvement Activities (IA), and Promoting Interoperability (PI). To prevent payment cuts in 2020, and to earn the maximum incentive, pathology labs must report on six Quality measures and up to two IA measures.
The future revenue cycle management of your lab depends on accurate documentation and proper reporting. It is critical to adjust front-office and back-office procedures to ensure maximum reimbursement from all payers. Credentialing plays a vital role in enhancing patient enrollment and insurance management. Effective denial management contributes to minimizing operating costs and maximizing revenue. Many insurance companies have narrowed their provider networks, and pathology labs are increasingly deemed out-of-network providers. Adding to the challenge is the fact that health insurers are placing greater limitations on benefits. It’s becoming more and more difficult to collect payments from insurers and patients alike. You may not be able to do anything about coverage, but you can avoid these types of denied claims and collection accounts by verifying eligibility before providing services.
Pathology practices face some of the most complex billing challenges out there. To succeed, they need to have a deep understanding of the intricacies of pathology billing—and the regulations that govern it. That’s where specialized expertise and knowledge of pathology medical billing services come in. Laboratory billing consultants can guide them through those complexities, offering expert advice on billing and revenue growth. By getting a handle on the billing process and laboratory billing services, pathology practices can streamline their revenue cycle management, reduce denials and increase cash flow. That support—tailored to their needs—ensures they stay on top of ever-changing regulations and get the reimbursement they deserve.
Many case studies and success stories prove the benefits of outsourcing in medical billing. For example a pathology practice that outsourced their billing to us reduced their denial rate by 30% and increased their cash flow by 35%. Another pathology practice that implemented our advanced billing software improved their charge capture by 20% and reduced their lost revenue by 15%. These success stories show the importance of specialized expertise in billing especially in pathology medical billing services. By partnering with a reputable medical billing company like Med Billing RES, pathology practices can manage their revenue cycle, reduce denials and improve patient care. These real life examples show the tangible benefits of outsourcing and technology integration, a roadmap for other pathology practices to follow.
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8655 Bay Parkway, Brooklyn NY 11214
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