Strategy is to use automation and new informatics solutions to improve productivity of medical lab’s billing and collection departments
Relentless pressure to cut costs is pushing the nation’s clinical laboratories to finally look at back-office functions as a source of important cost reductions. That is a new trend in the medical laboratory testing industry.
“No one should be surprised by this development,” stated Lâle White, CEO of XIFIN, Inc., of San Diego, California. “When it came to cutting costs, for the better part of two decades, most clinical laboratories put priority emphasis on the pre-analytical and analytical stages of their lab operations. This was a good strategy and has produced substantial gains in quality and productivity, even as labs were able to better manage costs. (more…)
Health insurers not eager to establish coverage for new molecular diagnostic assays
Navigating the pathway to successful commercialization of new genetic tests and molecular diagnostic assays has proven tricky. While scientists work quickly to bring new and better clinical laboratory testing tools to the market, health insurers work at a much slower pace to issue coverage guidelines and establish reimbursement for these new diagnostics tests.
“Successfully moving a genetic test from the research bench to the clinical laboratory takes much more than an understanding of the science,” stated Rina Wolf, Vice President of Commercialization Strategies for Consulting and Industry Affairs, XIFIN Inc., of San Diego, California. “Competition for coverage and reimbursement by health insurers is fierce. Often, the molecular diagnostic tests that win the best coverage decisions by payers are those proprietary tests backed by companies and laboratories with the most effective business plans.”
Management Tool Contributes to More Collected Revenue, Higher Sales Prices
Revenue Cycle Management (RCM) is hitting the radar screen at the nation’s best-managed clinical laboratories. That’s because shrinking reimbursement makes it imperative for clinical labs and pathology groups to collect every dollar legally due for the lab testing services they provide. RCM is a proven management tool for reducing unpaid claims and unlocking more productivity in the coding/billing/collections process.
“Revenue Cycle Management for laboratories encompasses all the administrative and management functions that contribute to the capture, and collection of revenue associated with lab testing services,” observed Lale White, CEO of Xifin, Inc. of San Diego, California. White has been an acknowledged national expert in laboratory coding, billing, and collections for more than two decades.