Enhance Pathology Revenue with a Smooth Billing Process



Constant change in the healthcare industry has impacted timely reimbursement for medical practices over the past few years. Pathology Medicare and Medicaid have gone on a reduction spree as far as physician reimbursements are concerned. Most third party payers like Cigna and Aetna are more keen on signing up contracts with physicians that focus on fee-for-service, where the reimbursement is less than 100% more often than not.  Here are a few ways to enhance revenues and have a perfect billing process in place.

  • Be Familiar with your LCDs

Pathology billing companies need to be familiar with Local Coverage Determinations (LCDs) and know the ins and outs of how they are related to various specialties and other frequently billed services. LCDs give a crystal clear picture about the instances when some procedures are covered by Pathology Medicare. They will also indicate the specific circumstances under which a procedure is considered appropriate and absolutely necessary. One can also find details on coding guidelines that facilitate reimbursement faster and without any hitches. 

  • Be thorough with your Electronic submission reports

Submission reports can come in very handy for a Pathology Billing Services provider while verifying various claims that are submitted. They can easily track the claims received by the payers. The reports also help keep track of the rejected claims, and know about the reasons why they were rejected. Pathology billing companies can intensely review such reports to ward off probable denials, and make necessary corrections and resubmit the claims immediately. Claims that did not reach the payers can also be investigated and scanned for errors, which can be corrected before resubmission.

  • Don’t give up on Denials

Denial is one tricky area that most Pathology Medical Billing companies dread, and probably end up spending too much time on. It is not that insurance companies are beyond reproach as they too make mistakes, as do most billing companies. The claim may have been billed accurately and the error could have been from the insurance company’s side. The best thing to do is to spend some time to thoroughly investigate such cases and work on them.  Pathology Billing companies need to devote some extra time to work on denials until they are paid.

  • Browse payer Websites

Most payers are bound to have websites of their own. It is worth the while of a Pathology Billing company to register on such websites in order to gain access to a lot of real-time information. One can easily establish a patient’s eligibility in a matter of minutes, which helps in collecting the patient’s share almost immediately. Registering on payers’ websites and taking advantage of the benefits accrued thereof makes perfect sense. It is easy to check eligibility, submit claims, and follow up to keep track of the status, all at the click of a button.

  • Be well Informed

As a Pathology Billing Services provider it is your duty to remain updated in your field of operation. With constant change taking place in the medical billing industry, it is important to keep abreast of changes as and when they take place. Not doing so will only add to the pile of denied claims and the subsequent financial losses can be averted by keeping yourself well-informed.  Pathology billing companies need to sign up for the periodic newsletters of payers. This helps receive coding and billing alerts regularly, which help in submitting accurate claims that make way for speedy reimbursement

A little care taken and a few steps followed can help in streamlining your Revenue cycle Management. This will lead to better profit margin, reducing denials and increasing revenue for your practice. Staying updated with current knowledge is deemed necessary for enhancing revenue.

This entry was posted in EMR / EHR / Health IT, Medicare Medicaid, Practice Administration. Bookmark the permalink.


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