Prevent Denials with Earlier Insight into Patient and Payer Information

April 30, 2021 By: Quadax

Increase lab reimbursement with a Patient Access Management solution 

Labs often do not get the same interaction with patients as a traditional provider in which they are collecting patient and payer information. A Patient Access Management (PAM) solution helps labs collect the necessary patient demographic and payer information successfully to be reimbursed for patient services.

With a PAM solution, labs no longer need to rely on providers to share this information, which often only includes basic patient demographic and payer information that is inaccurate, outdated or missing details. In many cases, labs receive demographic information in which the name is misspelled/misrepresented or the address is outdated or lacking specific payer plan information to truly understand payer coverage, payer rules, eligibility and patient responsibility. Unfortunately, this is usually not uncovered until well into accessioning or even once complete. For labs lacking this information, it can lead to billing errors and claim denials resulting in:

  • Delays, changes or even halts in patient care which can impact outcomes
  • Complex manual processes and their resulting costs
  • Surprise bills to the patient which has led to specific regulations regarding payer transparency
  • Increased days in A/R and/or lost revenue resulting in poor financial performance for the lab

With access to accurate demographic information on the patient, their insurance provider and plan details prior to or closer to the date of service, labs can avoid the costly domino effect of denial management.

Want to learn more? Download our Patient Access White Paper.  

 

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