Special Workshop 4

Proven Ways to Turbocharge Your Lab’s Coding, Billing, and Collec-tions Program to Generate Increased Revenue

Thursday, May 2, 2024 ● 8:00 AM – 4:00 PM

in many respects, today’s big story in revenue cycle management (RCM) for clinical labs and pathology groups is the arrival of tools powered by artificial intelligence (AI). These solutions are designed to automate the many manual processes involved in receiving a lab test claim, processing it, and submitting it to payers.

There are two primary benefits when automating the multiple manual processes involved in processing lab test claims. One benefit is that automation improves standardization and accuracy in claims review processes. The other benefit is cost savings that accrue because RCM staff become more productive. The daily volume of test claims in the typical clinical lab means that just these two improvements can trigger major cost savings while at the same time increasing collected revenue because of more claims are clean at first submission to payers.

Collectively, many developments in the art and science of clinical lab revenue cycle management mean labs have the opportunity to use new RCM tools and technologies to accomplish the following:

  • Collect more complete information on every lab test order placed by a referring physician, allowing labs to submit a greater proportion of complete and clean cleans to payers, thus speeding reimbursement from payers.

 

  • Use automation to verify a patient’s identification, address, insurance coverage, co-pay requirements, and more at the moment when the patient shows up to provide a lab specimen. This allows the patient service center to collect appropriate co-pays at the time of service.

 

  • Leverage AI-powered tools to compare—in real time—how a payer is reimbursing test claims versus the in-network contract terms the lab has with that payer. Now the lab is able to notify the payer of inappropriate payments.

 

Another topic for this important RCM workshop is the issue of outsourcing the RCM functions. Is it better to do coding and collections in-house versus using an independent company? You’ll learn the pros and cons of each approach, along with real lab case studies that document how to optimize the performance of your lab’s billing, coding, and collections efforts.

This valuable RCM workshop concludes with a session on new developments in lab compliance and regulatory issues associated with lab test coding, billing, and collections.

This RCM workshop is a “must attend” for your Billing Director and key team members. Space is limited, so act today to guarantee your place at this comprehensive, valuable opportunity to turbo-charge your lab’s coding, billing, and collections effort!

Session Details: Proven Ways to Turbocharge Your Lab’s Coding, Billing, and Collections Program to Generate Increased Revenue

Wednesday, May 1, 2024

5:00 PM - 7:00 PM
Reception and Exhibition

Thursday, May 2, 2024

7:00 AM - 8:00 AM

Continental Breakfast and Exhibition

7:45 AM - 8:00 AM

Introduction and Overview

Speaker to Be Named
Credentials,
Position, Organization,
City, State

Front End Billing Issues: Getting Full Data, Collecting from Patients Upfront; Insurance Verification

Every day, new products enter the RCM market that your lab can use to improve the completeness of incoming lab test requests from referring physicians. Similarly, there are new offerings that enable labs to verify a patient’s identity, insurance coverage, and co-pay requirements at the time of service. This session is anchored by a lab case study of RCM success, followed by short vendor presentations of their solutions.

Overview of Front-End Billing Issues

Speaker to Be Named
Credentials,
Position, Organization,
City, State

Executive War College Third-Day Workshop Company Presentations

Presentations by Companies with Solutions
Companies to be named.

Morning Break and Exhibition

Claims Rejected by Edit: Evaluating Claims and Fixing Errors to Resubmit Claims

It is the bane of clinical labs and pathology groups that payers regularly reject substantial numbers of lab test claims because they lack “all the required information.” Learn how one innovative lab addressed this issue. Hear from different RCM companies that have tools that address this problem.

Overview of g

TBFI
Credentials,
Position, Organization,
City, State

Executive War College Third-Day Workshop Company Presentations

Presentations by Companies with Solutions
Companies to be named.

Lunch and Exhibition

In-House vs Outsourced Billing: Weighing Pros and Cons: Essential Metrics for Effectiveness

What is the best way to evaluate the benefits of doing RCM in-house, compared to contracting with an outside RCM company? Expect this to be a provocative and illuminating session. Hear the advantages and disadvantages of each approach. Gain essential insights you can use to assess which approach may be most productive for your clinical laboratory or pathology group

Overview of ettings

Speaker to Be Named
Credentials,
Position, Organization,
City, State

Executive War College Third-Day Workshop Company Presentations

Presentations by Companies with Pathology Image Analysis Solutions
Companies to be named.

Afternoon Break

Managing Your Lab’s Managed Care Contracts: Real-time Checks to Monitor Proper Claims Payment

All too often, a payer will quietly change how it reimburses an in-network lab’s claims. In some cases, it may simply start paying less than the contracted rate. In other cases, the payer may ignore its coverage guidelines and deny those claims outright. This puts the burden on labs to monitor daily how their key players are ad-judicating lab test claims. Explore the new solutions entering the RCM market that automate the tracking and review of claims as submitted, as paid, or as denied. This session alone is worth your participation in this RCM workshop.

Case Study: Astems

C
Credentials,
Position, Organization,
City, State

Executive War College Third-Day Workshop Company Presentations

Presentations by Companies with Solutions
Companies to be named.

Compliance and Regulatory (Payer Audits)

Clinical laboratories and anatomic pathology groups are among the most-regulated healthcare providers. This session provides up-to-the-minute information about changing compliance and regulatory requirements in-volving coding, billing, and collections. It will also cover new developments in audits—both by the Medicare program and by private health plans.

Speaker To Be Named
Credentials,
Position, Organization,
City, State 

4:30 PM

Summary and End of Lab Coding/Billing/Collections Workshop

Speaker to Be Named
Credentials,
Position, Organization,
City, State

Space is limited. Register Today!

Who Attends the Executive War College

Health Systems and Hospital Clinical Laboratory and Pathology Leadership

Hospital C-Suite Administrators

Laboratory Vice Presidents

Pathology Lab Directors/Administrators

Laboratory Directors

Molecular and Genetic Lab Leaders

Precision Medicine & Genetic Program Directors/Administrators

Laboratory Section Managers/Leaders/Supervisors

Representative Labs:

  • ACL Laboratories/Advocate Health
  • Cleveland Clinic Laboratories
  • Medical University of South Carolina
  • Johns Hopkins Medicine
  • Baptist Health South Florida
  • Banner Health
  • Intermountain Health Outreach Labs
  • Baylor Scott & White Health
  • Cedars Sinai
  • Santa Monica UCLA Medical Center
  • Fabric Genomics
  • Kaiser Permanente

Independent Laboratories and Pathology Groups

Laboratory Owners/C-Suite/Vice Presidents/Directors

Pathology Group Owners/Directors

Pathology Group Practice Administrators

Physician Group Lab Owners/Directors

Public Health/Population Health VP’s/Directors

Life Sciences/Research Labs

Representative Labs:

  • Mayo Clinic Laboratories
  • ARUP (Reference Lab)
  • LabCorp (Reference Lab)
  • TriCore (Reference Lab)
  • GeneDx
  • Sonic Labs (Reference Lab)
  • Michigan Pathology Specialists (Pathologist Group)
  • Pacific Pathology Labs (Pathology Group)
  • NorDX (Animal Reference Lab)
  • Novartis (Research Pharm (Life Sciences)
  • AstraZeneca (Pharm/Life Sciences)
  • Caris Life Sciences (Pharm/Life Sciences)
  • Sonora Quest (Population Health Division)

Partners and Suppliers to Laboratory and Pathology Groups

In Vitro Diagnostic Manufacturers

LIS/Pathology LIS/LIMS/RCM/IT

Diagnostic Instrument, Product & Technology

Informatics Products and Services

Suppliers of Automation, Analyzers, and Assays

Revenue Cycle Management (RCM), Coding, Billing, and Collections

Legal, Regulatory & Compliance

Representative Companies:

  • Abbott (Diagnostics)
  • Epic Corporation (EMR/LIS)
  • Clinisys LIS
  • Cerner LIS
  • Telcor (Technology)
  • XIFIN (Technology/Informatics)
  • LifePoint Informatics
  • Change Health Care (RCM/billing)
  • HC1 (RCM)
  • Diagnostic Laboratory Services, Inc. (RCM)
  • COLA (Regulatory)
  • College of American Pathologists (Regulatory)
  • Beckman Diagnostics (Diagnostics)
  • Bio-Rad Laboratories (Diagnostics)
  • Hologic (Diagnostics)
  • Cardinal Health (Product & Technology)
  • Davis Wright Tremaine LLP (Legal)