Running a busy health lab definitely keeps you on your toes. Compared to a physician’s office, urgent care facility, or other place of healing, you likely will be seeing many more patients coming through your office every day. Because the lab test results are the foundation of 80% of clinical and medical treatment procedures. Therefore, healthcare labs also contribute significantly to the healthcare practices. 


Having said that, healthcare labs also need a full-fledged team to cater to those patients who visit your labs to fulfill their doctor’s orders for tests or get screened for using illicit substances. 

Along with the front desk staff that registers these patients, there is also back-end office staff that helps lab professionals to get paid for the services that they deliver to the patients after registration. Also, medical labs have different staffing needs than doctors and physicians. 

Managing Phlebotomists

For example, you’re managing phlebotomists and other professionals to take samples and conduct analysis (unless you have some of this work done off-site) instead of doctors, nurses, and physician’s assistants. The employees who schedule these tests have more work to do every day than the receptionists taking appointments for a typical doctor’s office, since the foot traffic is so much greater. 

Keeping everything organized and humming along properly depends on you computerizing your operations as much as possible so your team can work quickly and efficiently. It adds more burden to your existing task list. 

In order to reduce the work and pay more attention to delivering better quality patient care services, several healthcare labs tend to outsource laboratory medical billing services in the USA. 

Outsourced Medical Billing Services

According to a study, 70% of healthcare labs have outsourced medical billing services to lab billing companies. So if you’re worried to shift to advanced solutions and partner with a lab billing company then you need to consult an experienced and professional laboratory medical billing company. 

Whether you’re running an in-house medical billing or working with a third-party billing company, you must know what it takes to proceed with a medical billing system and how could you gauge the performance metrics of a laboratory billing team. 

What Is A Laboratory Billing System?

A laboratory billing system is a specialized medical billing system dedicated to healthcare labs. It is a well-defined approach to preparing bills for the services delivered by the healthcare labs and submitting claims to the insurance companies in order to receive reimbursements. It improves the financial health of the medical lab as well as motivates your staff to work at their best potential. Unlike a generate medical billing system, a laboratory billing system takes into account the unique requirements of labs. 

It makes sense to use an advanced laboratory billing system, integrate modern EHR solutions and hire professional medical billing specialists. Does it sound overwhelming and expensive? Well you can get all these things done at the fraction of your existing IT expenses by outsourcing laboratory billing services. 

If you want to stay in the know about how your lab billing system works, what are the right performance metrics of laboratory billing, and how could you make sure that your lab billing team is performing accurately then this guide would help you find your answers. 

How Does Laboratory Billing System Work?

Lab healthcare revenue cycle management starts right when the patient walks into your office and ends when you receive your reimbursements. It includes several steps, data accuracy, and professional expertise to carry out lab billing tasks. 

Here is the step-by-step guide to the laboratory billing system; 

1 Patient Registration

When your patient walks into your office then your front desk staff should collect the patient’s demographic information including; patient’s name, address, email, insurance ID, employment, etc. 

The registrations should collect the complete information verify accuracy and make sure that the data is up-to-date. If the data contains any error or it is outdated then it leads to several problems down the line including claim denials and rejections. 

2 Medical Coding

CPT, ICD-10, and ICD-10-CM are the most commonly used codes for clinical and healthcare labs. CPT-8000 series and ICD-10 code Z01.812 for Encounter for preprocedural laboratory examination is a medical classification as listed by WHO under the range. 

Lab coding specialist should understand the requirements of each codes to apply accurate codes. They should stay updated with the latest medical coding guidelines and stay on top of medical billing and coding requiremnets and regulations. 

3 Medical Billing

After applying codes, laboratory billing specialists should prepare and submit medical bills efficiently. Every insurance company has its own claim submission deadline. Therefore, lab medical billers should create a log to record the deadlines of each insurance company and follow the timeline in order to submit medical bills efficiently. 

4 Adjudication & Follow-Up

Medical billers should not leave their claims unattended after submission. It is the responsibility of the medical billing team to follow up with the clearing houses and insurance companies until you receive your reimbursements. 

It is important to follow up with clearing houses and adjudicate your medical claims. Keep reviewing the medical claims until you make sure that no errors and mistakes remain in the medical claim. 

5 Payment Collection & Posting

The last but least step of lab medical billing is reimbursement collection. After receiving the payments, medical billers should post payments in the billing software and update their records. It helps lab professionals to track down their payments and understand the paying behavior of their insurers and patients. 

With these insights, you can make well-informed decisions and understand how would you deal with your payers. 

Final Verdict:

Lab billing system is a time-taking and well-defined approach to claim your payments from insurance companies or carriers. The essential factors that ensure the success of a lab billing system are “accuracy” and “efficiency”. Lab billing and coding specialists should stay updated with the latest medical coding and billing standards to deliver accurate services.


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