Understanding Your Lab’s Revenue Cycle

Different types of lab tests face different revenue challenges. Cutting-edge molecular and genetic tests must meet payers’ medical necessity requirements, and require expertise to capture out-of-network reimbursement. Routine clinical tests typically have lower margins that are quickly eroded by billing errors. In every case, accuracy is paramount and details matter. At Quadax, we work to understand your lab’s unique reimbursement challenges. From pre-billing benefit investigation and prior authorization, appeals and patient advocacy, and BlueCard routing to automated MUE (Medically Unlikely Edits) and CCI (Correct Coding Initiative) edits, our expert solutions are optimized to deliver maximum reimbursement.

BPO Solutions

An experienced team of laboratory billing experts manages your revenue cycle operations to optimize results so you can focus on other areas of the business.

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SaaS Solutions

Have your billing operations team access our software on-demand via the secure Quadax cloud service without having to invest in costly hardware and maintenance.

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Hybrid Solutions

Gain the best of both solutions using a customized blend of SaaS and Outsourcing, optimized for your organization’s success.

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Patient Access Management

  • Fast, accurate eligibility verification
  • Patient financial impact calculator
  • Pre-certification, prior authorization processing
  • Document management integration
  • Automated workflow
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Claims Management

  • Automated claims-to-cash workflow
  • Industry-leading claim validation edits yielding 99.6% first-pass rate
  • Full visibility into processing rules and statuses
  • ONE seamless clearinghouse connection

Reimbursement Management

  • Fast, error-free posting
  • Co-mingled funds filtering
  • Integrated document management
  • Line item denials captured and routed through a customizable hierarchical workflow
  • Lockbox images indexed and stored electronically; 835s created for auto-posting
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Denials & Appeals Management

  • Sophisticated denials workflow to manage multiple levels of appeals
  • Timely filing with system-generated alerts
  • Appeals automation, repository for letters
  • Supporting documentation for tests

Business Intelligence

  • Dashboard displays, scorecard exhibits, and summary spotlights delivering real-time analytics
  • Key Performance Indicators to track productivity, work in-progress, expected revenue, and costs
  • Data mining at your fingertips for more granular analysis
  • Reliable financial source of truth for reporting and balancing
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patient engagement

Patient & Client Engagement

  • Information gateway where customers—patients and clients—can engage with you and exchange information
  • Customizable patient statement and client invoice templates
  • Compassionate and competent patient call center
  • Qualification of patients for financial assistance
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