What slips through the cracks can add up – 5 tips for Preventing Lost Revenue in your Lab

We live in an ever changing world, and the laboratory is no exception. Constraints on time, staff and training can make it difficult to stay ahead of the day-to-day demands while staying on top of changes that occur.

Here are 5 things you can do to insure that your Laboratory Revenue isn’t one of the things that changes – for the worse.

Keep your Laboratory Chargemaster up to date.

Tests offered by your laboratory can change over time. As test volumes change, high volume send outs become in-house tests and the low volume in-house test may change to send out. The addition or deletion of services offered at the facility often find the laboratory shifting tests as well. All of these changes need to be reflected in the Lab Chargemaster.

Review your Chargemaster(s) and billing tables on a regular basis. 

CPT codes are updated every October, make this your trigger for annual Chargemaster review. Review charge descriptions, CPT and HCPCS codes, revenue codes, charge dollar amount, department and internal billing codes as well as any appropriate lab specific information.

Compare your Lab Chargemaster to the Facility Chargemaster.

If any discrepancies are noted, work with the billing department to get them corrected. Ensure updates made on the Hospital financial side are documented and the appropriate updates or changes are made to the Lab chargemaster as well as the LIS billing tables. Always test to make sure they are working as expected.

Perform ‘round trip’ testing between LIS and HIS billing. (Laboratory and Hospital Information Systems)

Make sure to test any table changes or updates. The LIS may show that it is sending a billing charge to the HIS billing system, but that does not ensure everything is working correctly. The charge needs to make it from the LIS through the interface and file into the HIS billing system. Ensure all automatic charges are filing and posting correctly in HIS billing system.

Create an audit schedule for your manual billing and manual and automatic credit processes.

Because manual billing processes are less commonly utilized, they tend to slip through the cracks.  Test these processes to make sure they are posting in the HIS billing system as expected. Review charges are still valid given changes to reimbursement schedules. This review should be applied to credits as well. If your credits are applied automatically in the LIS, include them in the audit to make sure they are issuing correctly. Don’t forget to test your manual credit process.  As with charges, credits needs to make the round trip from the LIS through the interface and file into the HIS billing system without error. Ensure that all credits are filing and posting correctly in HIS billing system.

Time and resources are often limited, but this area of testing can literally pay for itself.  Finding issues and creating a system to prevent future problems can ensure that Laboratory Revenue stays in the Lab.  For more information about Billing Testing services provided by BC Solutions, please visit our website www.bcsolutionsrfn.com or call Rob Weatherford at (480) 346-7011.


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