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

Mick Raich, Owner, Mike Raich LLC

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

Dean Paluch
CEO,
Wave,
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.. 

Carlos Taborda, CEO, Gistia Healthcare

Carlos Taborda
CEO,
Gistia Healthcare,
Palmetto Bay, FL

Anthony D'Angelo, President Data & Analytics, Gistia Healthcare

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

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

Ann Lambrix
VP,
Revenue Cycle Management Solutions,
Lighthouse Lab Services,
Toledo, OH

Executive War College Third-Day Workshop Company Presentations

Presentations by Companies with Solutions
Companies to be named.

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, Partner, Robinson+Cole

Danielle Tangorre
Esq.,
Partner,
Robinson+Cole,
Albany, NY 

2:30 PM - 3:00 PM

Panel Discussion with Chair and Faculty

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 involving coding, billing, and collections. It will also cover new developments in audits—both by the Medicare program and by private health plans.
Mick Raich, Owner, Mike Raich LLC

Chair:

Mick Raich
Owner,
Mick Raich, LLC.,
Palmyra, MI

Dean Paluch, VP of Sales, Experian Health

Panelist:

Dean Paluch
CEO,
Wave,
Costa Mesa, CA

Carlos Taborda, CEO, Gistia

Panelist:

Carlos Taborda
CEO,
Gistia,
Miami, FL

Suzette Tidmore, Director, Revenue Cycle, Pathology Consultants of New Mexico

Panelist:

Suzette Tidmore
Director, Revenue Cycle,
Pathology Consultants of New Mexico,
Las Cruces, NM

Ann Lambrix, VP, Revenue Cycle Management Solutions, Lighthouse Lab Services

Panelist:

Ann Lambrix
VP,
Revenue Cycle Management Solutions,
Lighthouse Lab Services,
Toledo, OH

Danielle Tangorre, Attorney, Robinson & Cole LLP

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, Mike Raich LLC

Mick Raich
Owner,
Mick Raich, LLC.,
Palmyra, MI

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)