Pathology Practice Management Issues

Healthcare is an ever changing and competitive environment; where pathologists are not barred from bearing the brunt of these changes in form of unique challenges and anxieties. These issues could be related to revenue cycle management, compliances, contracts and/or growth. And to keep up in this altering scenario, pathologists too need to be well-trained like a specialist as in any other medicine specialty. Continuous innovations in technology require pathology business leaders and practice administrators to ensure that no money is left on the table and work towards maximizing the compensation of pathologists.

Challenges in Pathology-
Various issues become a part of the Pathology practice management and can greatly hamper the billing and coding for the practice, thus resulting in lower reimbursement. This hits the bottom line of the practice, having it run into losses. Pathology services are associated with a stream of tests to be conducted for the diagnosis of a disease. After these tests are conducted, the physician begins the apt treatment for the patient. It is the physician, many times, who decides which pathology service should the patient use. If the pathology company notices that they are beginning to lose business on a regular basis, it's time for up gradation of skills and practice. This indicates that pathologists need to be fellow-ship trained in dermatology, urology, hematology etc. The pathology practice needs to tap into specialty expertise for gaining references and movement for an increase in the revenue cycle.

Pathology practice management leaders need to identify ways to step up their practices for enhancing their revenue cycle by ensuring better reimbursements. Pathology services often suffer from payers’ payments as the latter tends to get deep into contracts and not pay for things they were paying for in the past.

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Therefore, measures to enhance the pathology practice management are:

1. Usage of lean methods to manage and improve the workflow thereby enhancing the quality of the products.
2. Upgradation of the automation and technology (e.g. histology, digital imaging etc.).
3. Provide online access to reports, which is convenient for doctors and patients to view in real time.
4. Create 'dashboards' or 'flash reports' which gives access to data online and not on paper.
5. Construct strong managed care contracts (51% rule) and increase sales and marketing.
6. Understand the margin per case and benchmark pricing.
7. Working with large payers gains a foothold in an area with low provider coverage.
8. Discover the problem with insurance payment, if any. Include some joint venture arrangements if experiencing increased receivables and billing costs coupled with reduced services.
9. Differentiate via services: gamut of care, turnaround time, accessibility. Capitalize on skills, contacts and knowledge.
10. Focus on obtainable business. Discover the potential of a less populated area, referrals from physician group clients and lower-volume generating customers.

Managing and practicing pathology implies creation of opportunities, growing the practice and providing expertise to the community. Including consequential training in pathology practice management and informatics to satisfy the requirements of skillfulness in pathology will prove beneficial.

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Published By - Medical Billers and Coders
Published Date - May-05-2016 Back