With an industry-wide focus on patient satisfaction and a clear shift of revenue responsibility from insurance carriers to patients, it’s never been more important to minimize wait times and customer perception. At the same time, administrative responsibilities continue to expand as payers increase expectations and, in the Laboratory, whether hospital-based or free-standing, those functions often end up the responsibility of the technical staff.
From determining how much to collect at the time of service to either initializing or following up on the prior authorization process, lab testing has a fluidity that can change as physician orders are received and continually updated. As automation makes major headway into the patient access process, forward-focused organizations are finding opportunities to improve revenue reimbursement, reduce denials, and positively impact the workflow of the technical staff.
Freeing Up Technical Lab Staff and Cutting Costs
What if you could design a workflow that significantly improved the patient’s visit while reducing the amount of administrative paperwork lab techs are required to do and reducing errors and backend follow up? The cost containment would reach far beyond the lab bench, impacting the entire healthcare payment lifecycle.
Through automation and harnessing the incredible power of Artificial Intelligence (AI), systems can be put in place that would reduce hands-on tech time in the following ways:
- Prior Authorizations – Automate your prior authorization workflow with AI-driven software that provides you with accurate real-time data and exception handling by certified specialists for outliers and emergent or STAT requests. Prior authorizations continue to negatively impact the laboratory workflow because of the manual, labor-intense submission process, not to mention the time required for follow up and tracking approvals. With an augmented intelligence solution, your staff members are freed up to focus on the quality of care that’s so important to patient outcomes.
- Patient Pay Estimation – Collecting patient portions due at the time of service is more important than ever as costs have shifted by more than 30% to the patient, due to high-deductible health plans. By automating the estimation process, the correct amounts can be collected when a patient presents for testing which lessens the need for backend follow up and collections.
- Propensity to Pay – By focusing on integrating a propensity to pay component you can leverage machine learning and AI capabilities to analyze a patient’s ability to pay based on a propensity to pay score. This allows lab staff and their billing support teams to prioritize their collections time and energy.
Utilizing software that seamlessly integrates with existing electronic health records and billing systems creates a scalable solution that could be expanded as technology becomes available. The savings in staff time would be evident in both the lab and billing teams, freeing them up to address patients’ needs. Additionally, as the payer industry becomes more complex, a foundation of AI-enhanced technology would already be created and automation could be expanded to meet future needs and requirements.
Contact us to find out more about streamlining your Pathology and Lab healthcare billing lifecycle.