Nearly 60% of insured adults have received a surprise bill on a healthcare service they thought was covered by insurance. And whether care or the provider is in-network, out-of-network or a mix of the two, 1 in 5 of these insured adults find it difficult to pay their deductibles.2 Why is this happening and what is being […]
There are two pathways under the Quality Payment Program (QPP): MIPs and Advanced APMs. Unless you qualify as a participating clinician in an Advanced Alternative Performing Model, MIPS will be your default. MIPS has four weighted performance categories, identified below. This post will focus on Quality and Cost. Quality Improvement Activities Promoting Interoperability Cost As […]
Reimbursement in out-of-network care has grown to $60B and continues to grow due to the proliferation of narrow networks. Many providers don’t play in the out-of-network space or write-off a big chunk of revenue to close out an aging A/R. So what does an organization need to do in order to maximize reimbursement in this arena? According […]
PAMA has already made a significant impact for hospital and independent labs, and continues to do so with the redefinition of an applicable lab. PAMA has expanded the number of reporting labs to include smaller labs and hospital outreach labs. CMS estimates at least 43% more labs are now required to report under the new […]
Solve issues early. Collect payment faster. Discover the benefits of engaging patients early, getting ahead of revenue cycle problems— stopping claims from turning into denials or resubmissions— by collecting correct patient information at the point of care. Learn new strategies to reduce time from DOS to claim generation and increase visibility into revenue flow through the […]
Take a deep dive into consumer trends impacting the revenue cycle of clinical labs and best practices in patient access management.
Patients’ financial liability in paying for healthcare services is almost unrecognizable from that prior to the early 2000s; yet many organizations, including clinical laboratories, have struggled to modernize their collection practices in turn. As a result of this mismatch, labs risk not just losing out on uncollected revenue, but also wasting time and resources on […]
Keeping you in the know on the world of medical billing and reimbursement, this issue brings you a digest of stories impacting the lab industry.
In many traditional lab organizations, the scientific product development group has historically produced new diagnostic tests without meaningful input and consideration of payer policy and revenue cycle demands. But what if the lab were to begin considering the needs of the revenue cycle even earlier? What if revenue cycle considerations were included in the lab’s decision-making […]
CLEVELAND, January 14, 2019 – Quadax Inc., a healthcare information technology leader in providing revenue cycle optimization software and services, will present strategies for laboratories to improve collections and reduce administrative burden at the 14th Semi-Annual Q1 Diagnostic Coverage & Reimbursement Conference West. The conference takes place at the Hilton Garden Inn San Diego Bayside from […]