Creating an Effective RFP

  • Feb 14, 2019

How to Ensure Your RFP Communicates Your Vital Company Needs so it Reels in the Best RCM SolutionsMany diagnostics providers interested in gathering competitive information and looking to replace their revenue cycle management (RCM) systems use the traditional request for proposal (RFP) process. However, the concern is whether a company's traditional RFP process has kept up with the RCM industry...

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PAMA: The Nitty Gritty on Labs Affected & What’s Required

  • Feb 12, 2019

As labs prepare for 2019, it is important to understand what has taken place this past year, and what is to come in order to move forward amicably without hitting the same barriers and roadblocks presented by PAMA in 2016. As you can see in the chart below hospital = outreach and physician office laboratories (POLs) were underrepresented in 2018 making solid reporting a key to mitigating future...

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Is Your Appeals Process Effective?

  • Feb 5, 2019

Over the last several years, the healthcare industry has undergone an enormous amount of scrutiny and restructuring. From the entrance of Affordable Care Act Health Plans to close examination of utilization trends and a significant increase in the patient burden related to the cost of healthcare, it has become increasingly challenging for healthcare providers to be paid for the services rendered...

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Helping you get “In-Network” Coverage – Faster and Easier

  • Jan 25, 2019

Achieving “in-network” coverage with payors for new or differentiated diagnostics, technology, or remote patient monitoring devices can provide significant advantages for novel diagnostic and medical device companies. The first step in gaining these advantages is getting payors to cover a new test or device for the applicable patient indications. The next step is to negotiate a favorable price...

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Can Your Revenue Cycle Management (RCM) Solution Keep Up with Your Future Plans?

  • Jan 24, 2019

Shrinking reimbursements and increasingly complex regulations are squeezing the profits of clinical laboratories. As a result, many clinical laboratory leaders are being forced to consider their strategic options, including reorganizing, restructuring, merging and or otherwise consolidating with another laboratory, or selling. This means laboratory leaders need to be closely assessing their...

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Leveraging the Transformation of the CIO

  • Jan 17, 2019

The role of the CIO is changing. One of the ways in which this change is evident in the healthcare industry is through the transformation of the technology purchasing process. According to Gartner, CIOs going forward will be more deeply involved in differentiating technology and managing the flow of information in the context of customer interactions to foster better engagement.1 This can...

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Data Quality Is a Cornerstone to Effective Revenue Cycle Management

  • Jan 17, 2019

One of the most challenging obstacles to diagnostic providers getting paid on time for their services is a lack of accurate patient data. Many laboratories struggle with the quality of the data that they receive and because they often lack direct access to the patients, it can be an expensive, manual process for lab team members to chase down incomplete, incorrect, or missing data that is...

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A Conduit for Real-Time Lab Data Exchange

  • Jan 16, 2019

For labs looking for a conduit that allows for the pre-scrubbing of claims to ensure the likelihood of acceptance from the patient’s insurance provider, web services are the answer (Generically, a web service is any standardized software system designed to communicate with another system over the web; here, I will be referring to a specific set of web services created for the healthcare industry...

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