Special Workshop 5
Proven Ways to Turbocharge Your Lab’s Coding, Billing, and Collections Program to Generate Increased Revenue
Thursday, May 2, 2024 ● 8:00 AM – 4:00 PM
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 used to process 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 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
8:00 AM - 8:30 AM
Introduction and Overview
Workshop Chair: Mick Raich
Mick Raich
Owner,
Mick Raich, LLC.,
Palmyra, MI
8:30 AM - 9:10 AM
Front End Billing Issues: Getting Full Data, Collecting from Patients Upfront; insurance Verification
When patients show up to provide lab specimens, it is the perfect time for labs to ensure they collect all the information needed to run the tests and bill the payers. New capabilities—some powered by artificial intelligence—are already being used by labs that, at the time of service, almost instantly verify a patient’s identity, along with the patient’s insurance coverage and co-pay requirements.
Dean Paluch
VP of Sales,
Experian Health
Costa Mesa, CA
9:10 AM - 9:50 AM
Real Time, Dynamic Monitoring of Incoming Test Claims and Payer Decisions That Optimize Lab Revenue
Practical day-to-day utilization of data analytics and AI in laboratory operations that drive increased lab revenue performance.
Discover how you can benefit from these cutting-edge technologies and best practices..
Anthony D’Angelo
President Data & Analytics
Gistia Healthcare,
Miami, FL
9:50 AM - 10:20 AM
Morning Break and Exhibition
10:20 AM - 10:50 AM
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.
Suzette Tidmore
Director, Revenue Cycle,
Pathology Consultants of New Mexico,
Las Cruces, NM
10:50 PM - 11:30 PM
In-House vs Outsourced Billing: Weighing Pros and Cons: Essential Metrics for Effectiveness
This session will discuss the advantages and disadvantages of outsourcing some or all of the revenue cycle. What are the key factors to consider when evaluating this decision? What are some pitfalls with each and how do we avoid them? Expect this to be a provocative and illuminating session. Gain essential insights you can use to assess which approach may be most productive for your clinical laboratory or pathology group.
Ann Lambrix
VP,
Revenue Cycle Management Solutions,
Lighthouse Lab Services,
Toledo, OH
11:30 PM - 12:30 PM
Lunch and Exhibition
12:30 PM - 1:45 PM
Unite Your Lab’s LIS & RCM Workflows, Reduce Time Spent in A/R, and Turbocharge Net Collections
LIS system and lab revenue cycle management data are interdependent so why not integrate them into one efficient, accurate, and transparent laboratory billing process that starts as the order enters the lab?
In this session, Jenny Bull, Chief Operating Officer at Avero Diagnostics, will discuss what caused lab leadership to move away from the traditional in-house lab billing model and embrace the benefits of an all-in-one informatics platform – one that features embedded LIS and RCM modules linked to a shared database and software infrastructure.
Since making the switch, the dreaded data silos have been replaced by end-to-end data integrity, previously manual tasks have been replaced by automation, and unlike before, the lab now has an unprecedented level of operational and technical visibility.
Jenny will highlight how Avero Diagnostics’ now transparent and seamless informatics environment is optimal for accurate coding and revenue capture, and how this has helped protect the lab from negative trends like high denial rates, increasing labor costs, constantly changing payer requirements, and more exposure to compliance risk. She’ll also emphasize the need for more labs to make billing a frontend priority rather than a backend and disconnected process.
Jennifer Bull
Chief Operating Officer,
Avero Diagnostics,
Bellington, WA
1:35 PM - 1:50 PM
Afternoon Break
1:50 PM - 2:30 PM
Update on Changing Regulatory, Compliance, and Payor Contracting Issues
In 2024, laboratories are facing a challenging regulatory and operating environment with an ever-present focus by payors on billing compliance. During this workshop, Health Law Partner, Danielle H. Tangorre will explore the latest changes, providing key insights to help you effectively address evolving regulatory and compliance challenges, and optimize your approach to addressing payor audits and billing. She will discuss the primary challenges and legal intricacies of the shifting landscape, while providing practical strategies to navigate regulatory shifts, compliance challenges, and the nuanced world of payor audits. Topics covered will include:
• Overview of Regulatory & Compliance Standards;
• Common Areas of Noncompliance;
• Implications of Noncompliance; and
• Potential Strategies for Mitigating Compliance Risk;
Danielle Tangorre
Esq.,
Partner,
Robinson+Cole,
Albany, NY
2:30 PM - 3:00 PM
Panel: Question & Answer with Summary
Chair:
Mick Raich
Owner,
Mick Raich, LLC.,
Palmyra, MI
Panelist:
Dean Paluch
CEO,
Wave,
Costa Mesa, CA
Panelist:
Anthony D’Angelo
President Data & Analytics
Gistia Healthcare,
Miami, FL
Panelist:
Jennifer Bull
Chief Operating Officer,
Avero Diagnostics,
Bellington, WA
Panelist:
Ann Lambrix
VP,
Revenue Cycle Management Solutions,
Lighthouse Lab Services,
Toledo, OH
Panelist:
Danielle Tangorre
Attorney,
Robinson & Cole LLP,
Albany, NY
3:00 PM - 3:10 PM
Summary and End of Lab Coding/Billing/Collections Workshop
Mick Raich
Owner,
Mick Raich, LLC.,
Palmyra, MI
Space is limited. Register Today!