Movement continues on CMS reimbursement of Advanced Diagnostic Laboratory Tests (ADLTs) and Molecular Pathology testing during the 14 days following a hospital stay.
When it comes to healthcare claims, cleanliness is next to, at the very least, fiscal fitness. Producing claims that are “clean” and therefore immediately reimbursable is an important factor in reducing cost-to-collect, especially in an environment where the growth of costs (7.5%) are outpacing revenue (6.6%).[i] While some denials are inevitable, reducing your denial exposure is all about [...]
Automation is more and more important in today’s patient financial services office. Shrinking margins dictate smaller teams, while the complexity of achieving reimbursement only increases. In that environment, being able to rely on advanced, highly-automated technology is essential for your efficiency…and your sanity.
How are some of the payers’ Prior Authorization (PA) programs impacting your laboratory’s bottom line and what can you do about it? Increasingly, retroactive authorization after performing lab tests is becoming a less viable option; as is fighting denials for lack of Prior Authorization during the appeal process. While some payers still allow retroactive authorization, in general, laboratories [...]
Increasing financial pressure related to changing healthcare economic realities requires the pursuit of continuous improvement and streamlined productivity. To attain continuously advancing revenue cycle goals, every element of your business office system must be a high-performing contributor – especially your claims clearinghouse.