Most of today’s laboratories and diagnostic providers are running on relatively slim profit margins. This is truer than ever, due in part to lower reimbursements resulting from the 2014 Protecting Access to Medicare Act (PAMA) pricing exercise and the associated clinical laboratory fee schedule (CLFS) that came into effect in early 2018. Also at play are challenges with payor reimbursements including denials and appeals. Loss of revenue can lead a leadership team toward the temptation of deferring investments as a way to protect cash flow and profits. This can be an expensive mistake when the investment is in technology that increases revenue, streamlines and expedites claim reimbursement, and boosts operational efficiencies.
As you weigh whether or not to invest in billing technology or revenue cycle management technology, it’s important to understand the true cost of accepting and maintaining the status quo. Frankly, doing nothing has very tangible opportunity costs and business risks associated with it.