Pathology is a discipline that affects all other practices in the healthcare industry. Pathologists play a role in both diagnosis and treatment by providing accurate laboratory results. A pathology practice can be a stand-alone unit, or it could be a part of a larger healthcare organization, and in both cases, you need to be supported by effective backend teams to handle billing and reimbursements.
Medical billing and coding companies need to be extremely experienced and understand the practice to be able to work with pathology labs. Everything from documentation to using the right codes and modifiers improves the chances of converting claims into successful reimbursements.
As a pathologist, you often deal with the extreme pressures of being clinically precise and efficient. The slightest errors can change the course of treatment and affect the patient’s prognosis. That’s why it is not a smart move to try and do everything in-house. Even after providing exceptional service, a pathology service can struggle to sustain itself if it is not able to get bills reimbursed at the right time.
Here are five ways to improve medical billing and coding practices for pathology
1. Know your stats right and work on the fundamentals
How can you fix a problem without understanding what it is? Many practices end up implementing changes that people suggest without understanding if that’s actually going to bring any results. When we say know your stats right, we mean that as a pathology practice, you need to know how well your current billing and coding services are performing.
Medical billing and coding companies like Quintessence dives deep down and understands customer problems before even deciding to work for them. That means knowing the current reimbursement rates, denial rates, touches to closure, collection ratios, and other baseline reports to know what’s happening right now and the expected changes.
Going through this process the right way will help solve fundamental problems and provide long-term results for the lab practice. Do not rush into solving problems, and do not sign with medical billing and coding companies that promise exceptional results on day one. Accepting to work on fundamentals is important if you want to improve medical billing and coding processes.
2. Make sure your RCM process is streamlined, efficient, and well-designed
Your end revenues and success depends on every step in the Revenue Cycle Management process your team follows. Just one step of your RCM could have a problem, leading to the whole cycle becoming inefficient, and ending up swallowing revenues. Either your inhouse team or your partnered Medical billing and coding company have to work on the RCM processes in-depth to ensure changes reflect visibly the revenue generated and bills reimbursed. Trying to follow up with the payers consistently without making changes to your existing RCM is going to be efforts gone in vain.
Quintessence is one of the industry experts when it comes to streamlining the existing RCM processes of healthcare clients. We start analyzing every step of your RCM, starting from data management to denials and AR follow-up, and help tweak them, so they get more efficient. Quintessence’s tools can be integrated easily into your existing RCM set-up, so it is easy to bring about changes without having to invest a lot of time and energy into this.
We tackle the administrative, clinical, and regulatory parts of your business so you can focus on treating your patients.
3. Invest in technology
Technology has become the backbone of the medical billing and coding industry. While the human effort can never be replaced, as a medical billing and coding company with decades of experience, we have seen that technology can be the strategic difference in helping billers and coders get more efficient, precise, and confident about their tasks.
As a pathology practice that wants not just to survive but flourish as a business, you need to lean towards technology to handle your backend tasks. Unsurprisingly, making such investments as a small practice can affect your business costs and seem impossible. That’s why it makes sense to hire a third-party service provider who is already equipped with the needed technical expertise.
Quintessence has invested intensively in the latest Automation (RPA) and ML-based tools to support our workforce and our clients. Tools like Reimburssence, Codessence, and Doctor’s Portal are all our pride, and almost all our existing clients make use of these tools to tighten their processes and get more efficient. Most of our RCM enhancer tools are bundled with our services and are easily affordable for practices to use.
4. Keep up with guideline changes in the industry and with the payers
Your billing team could be dealing with different insurance payers regularly. However, if they fail to keep up with what’s happening at the payer’s end, they will miss critical guidelines changes that may cause a majority of your claims to get denied suddenly.
Your payer may change the guidelines subtly so a particular new document is made compulsory for claims to go through or requiring the addition of a modifier to a certain treatment code. If the team isn’t aware of this and keeps sending claims like before, it will lead to denials, expensive appeals, constant follow-ups, and more such complications.
Remember that these are time-consuming affairs. As a result, your bills may get stuck without getting paid for months together, affecting your financial position.
Medical billing and coding companies need to constantly be aware of what the payers are up to and maintain cordial relationships with them. Hire a company that understands the importance of staying up-to-date.
5. Hire the right medical billing and coding companies to take over the process for you
For many growing pathology practices, handling an in-house billing and coding team may not be the best idea. If you decide to hire third-party medical billing and coding companies to take care of your backend processes, then make sure you choose them right.
There are companies that promise minimal SLAs and meet them, and there are others like Quintessence that act as your partner and not a mere service provider. As a result, we partake in your risks, work on a contingency-based fee model, so it is easy for you to start working with a third-party provider, and offer expert insights and analytics to help you grow.
As a pathology practice that’s busy all through the year, hiring right medical billing and coding companies to take over your backend billing and coding can be a game-changer for you. You can streamline your billing management cycle and tweak your RCM steps, so they get more effective and reap better returns with time.
Quintessence is a SOC II Type II and HIPAA-compliant organization and specializes in handling billing and coding for different segments of pathology, including drug screening, Immunohistochemistry, ISH procedures, clinical and molecular pathology tests, and biopsies. Our team ensures the documentation is perfect, and our coders know what codes and modifiers need to be used for the specific services rendered. Our tools and technology support them in making the right call on different encounters.
If you are a pathology service provider looking for a billing and coding team to support you as you grow, get in touch with us right away.
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