Medical laboratories face new revenue cycle challenges for the diagnostic services they provide. With inpatient volumes low and reimbursement rates down, new approaches to billing and accounts receivables are essential. Every dollar counts. Every accession matters.
And even though outpatient laboratory volumes are high, their associated revenue is at risk. Poor patient demographics and unknown insurance coverage accompany most accessions. Without effective methods to fill the gaps, laboratories leave revenue behind or are forced to pay high contingency fees to collection agencies.
Labs can no longer afford to write off unreimbursed tests. Nor do they have extra time, money or staff to chase down patient addresses, active insurance coverage or delinquent accounts. Payor Logice reduces laboratory bad debt and improves cash by identifying the correct payor source—every accession, every payor, every time.
Identify Correct Payor Source
Payor Logic starts by obtaining accurate patient information for each accession. We work with you to determine the correct payor source by either verifying furnished coverage or discovering coverage for your entire population. The result is newfound payor sources yielding faster, more successful claims submissions. And more dollars to your bottom line in three important ways:
- Recognize increased revenue
- Reduce accessions without coverage by more than 10%
- Verify demographics and obtain correct responsible party the first time
Benefits for Laboratory Services
Payor Logic customers find millions of dollars annually through correct demographics and insurance coverage for every accession, including insurance discovery on your self-pay population. We apply technology and billing expertise—without adding more work to your billing workflow. Specific laboratory benefits include:
- Scrub self-pay accessions for 3rd party coverage automatically
- Quality self-pay for charity, hardship or presumptive Medicaid
- Determine propensity-to-pay
- Realize upwards of a 6:1 return on investment
- Reduce manual intervention and return mail
- Minimize write-offs, labor hours and collection agency expense
“Every day we receive specimens with little or no demographics. Payor Logic finds accurate information for each accession—without adding steps to our workflow.” Large Regional Clinical and Specialty Testing Laboratory