Laboratory Information Management System - PROLIS
medical billing

Laboratory Revenue Cycle Management: A Guide

Laboratory Revenue Cycle Management

The healthcare industry across the globe has undergone a huge transformation. Healthcare providers are now required to provide improved patient care while reducing operational costs. Whether it is a large hospital, an urgent care center or a private clinic, revenue cycle management has become an important factor in any practice for enhancing patient services and lowering expenses.

What is Revenue Cycle Management?

What is revenue cycle? The revenue cycle in laboratories involves managing patient registration and scheduling, coding diagnosis and procedures, collecting payments, and reviewing medical services. According to a recent study by Black Book Research (a healthcare analysis organization, 92% of top-level executives in healthcare sectors are now focusing on revenue cycle management (RCM). Focusing on your laboratory’s RCM is essential because studies have found that 30% of medical facilities are still not able to fulfill their yearly net revenue expectations.

Laboratory Revenue Cycle Challenges

Laboratory revenue cycle management is a complex process. A practice has to bear all the medical costs themselves before it can be paid in full by the patient or his or her insurance company. There are a number of factors that are critical for a better financial position of the lab, such as maintaining an accurate patient database, having a proper billing process, and improving point-of-service receivables. When these things are ignored, labs face a number of challenges:

  • A high number of unbilled claims
  • A high denial rate
  • Fluctuations in gross collection rate
  • Too many bad debts
  • Low monthly net collections
  • and many more…

Why Labs Need Medical Laboratory Software for RCM

Healthcare organizations need to deploy designated medical laboratory software for revenue cycle management. A RCM system can help to automate the administrative tasks, such as patient scheduling, reminders, payment information, and to reach out to insurance companies. Here are the benefits of using RCM software:

  • Optimized Billing Process: Calculating denial rate, net collection rate, first acceptance rate, A/R, etc., is time-consuming and prone to human errors. With a laboratory billing system, you can capture patient and service cost data to calculate everything automatically. With actionable reports on each aspect of the lab operations, you can quickly identify the problem areas and take actions accordingly.
  • Efficient Lab Operations: Centralizing lab database helps to standardize the lab operations, increases profitability, and opens new revenue opportunities. You get analytical information and reports from your medical lab software that enables you to get an overview of inefficient procedures and improve patient engagement to reduce unbilled claims and denial rates.
  • Meet Compliance Goals: Health systems often face mounting pressure due to ever-evolving compliance and regulatory environments. With protected and accurate patient and financial data in your RCM system, your practice stays compliant with healthcare regulations.

Prominent RCM System Vendor

American Soft. Solutions Corp. offers a comprehensive medical laboratory software – PROLIS – which has a billing solution integrated into it. It is a suitable option for automating your revenue cycle management process and streamlining core operations in your lab. You can even manage multiple labs such as toxicology lab, clinical facility, health system, pathology center at one place using PROLIS.

Conclusion

The revenue cycle of your health facility plays a significant role in driving profitability. Use medical laboratory software to make your revenue cycle management as smooth as possible and to improve the flow of revenue.