Laboratory Revenue Cycle Management
Next-Gen Laboratory Revenue Cycle Management
It’s a new day in healthcare and progressive, next-generation laboratory revenue cycle management tools that boost financial performance are essential. Commercial labs, hospital outreach labs and imaging centers must find smart ways to grow their profitability, while compliant with modern digital requirements.
With labs and imaging centers continuously competing for decreasing reimbursements, and losing millions as payers shift to negotiated payment models, taking operations to the next level while adapting to shifting payer demands simply cannot wait.
Up to 45% more revenue & 95% payer acceptance rates
Imagine just one service that boosts lab revenue as much as 45% through an automated authorization and up-front eligibility confirmation process… and a claim management process that bumped payer acceptance rates to 95% and higher, while resubmitting adjusted claims that were denied in less than 48 hours.
It’s revolutionary, and it’s changing the laboratory landscape forever.
No more manually entered paper lab orders, no more mismatched patient records that trigger duplicate records, and no more unbillable or denied claims.
4medica’s automated order process reduces errors, increases billable revenue and protects against audits—all at a fraction of the time and cost it takes to manually process an order.
One of the industry’s first technology companies to introduce electronic connectivity between providers and labs, 4medica has the solid experience to help you increase profits. Our clients see an average increase of 50% or higher in patient collections.
How do we accomplish this? Perfect payments begin with a perfect order. 4medica’s patented orders management platform creates perfect orders using a highly sophisticated rules-based engine to validate patient demographics with patient matching in real time, assists with insurance eligibility and handles pre-authorizations as part of the upfront ordering process to streamline workflow.
Schedule a product demo or talk with one of our revenue experts today!
Pre-Authorizations
Providers are looking for any help they can get to fulfill insurer requirements for prior authorizations. If your lab can process authorization requests for diagnostic tests, it will become the preferred lab in your community. With 4medica, every order is translated into an electronic order and fully scrubbed upfront for medical necessity, patient identity, insurance eligibility and pre-authorization.
Billing and Collections
Collect more at the point of service—and bring millions back to your bottom line. 4medica helps labs reduce denials and improve their overall payer reimbursements by offering unique integrated collections management modules to help labs collect patient co-pays, deductibles and out-of-pocket requirements at the time of service.
Denials Management
Claim denials cause sizeable revenue leakage. Besides software, we offer onsite analysis to review top denials by payer and help you determine the root or hidden cause. Armed with this revenue cycle intelligence, you can inform practices or connected providers about details such as pre-authorization requirements. This strategic consulting service helps you better manage why denials occurred in the first place and how to prevent them in the future. Our team of experts also works denials to net higher reimbursement if probable cause was assigned inappropriately.
Laboratory Revenue Cycle Advisory Services
Payer rules and legislation change constantly and it’s hard for labs and imaging centers to keep up. Our team of consultants identifies opportunities and develops strategies based on deep experience and best practices in revenue cycle enhancement. We provide comprehensive performance assessments that leverage technology to identify and close gaps and produce sustainable results.
Pre-Authorizations
Providers are looking for any help they can get to fulfill insurer requirements for prior authorizations. If your lab can process authorization requests for diagnostic tests, it will become the preferred lab in your community. With 4medica, every order is translated into an electronic order and fully scrubbed upfront for medical necessity, patient identity, insurance eligibility and pre-authorization.
Billing and Collections
Collect more at the point of service—and bring millions back to your bottom line. 4medica helps labs reduce denials and improve their overall payer reimbursements by offering unique integrated collections management modules to help labs collect patient co-pays, deductibles and out-of-pocket requirements at the time of service.
Denials Management
Claim denials cause sizeable revenue leakage. Besides software, we offer onsite analysis to review top denials by payer and help you determine the root or hidden cause. Armed with this revenue cycle intelligence, you can inform practices or connected providers about details such as pre-authorization requirements. This strategic consulting service helps you better manage why denials occurred in the first place and how to prevent them in the future. Our team of experts also works denials to net higher reimbursement if probable cause was assigned inappropriately.
Revenue Cycle Advisory Services
Providers are looking for any help they can get to fulfill insurer requirements for prior authorizations. If your lab can process authorization requests for diagnostic tests, it will become the preferred lab in your community. With 4medica, every order is translated into an electronic order and fully scrubbed upfront for medical necessity, patient identity, insurance eligibility and pre-authorization.
Perfecting Your Laboratory Revenue Cycle Management Process
Download our white paper “Perfecting Your Lab Profitability and Ordering Process” to gain operational insight and advice from some of the nation’s leading experts. Learn why more efficiency throughout the entire order management process will drive laboratory revenue cycle management.