Poor reimbursement, confusing payor arrangements, and difficulty reconciling complex lab invoices…all of the difficulties inherent in laboratory billing were plaguing this six physician endocrinology practice. This group had been billing for their lab services in-house for two years and had incurred a massive liability to their reference lab. Simply put, their collections were not covering the cost of their testing.
The practice engaged Phytest to help sort through its existing lab payables in order to stem the negative cash flow associated with their internal billing operation. We worked with the practice on a three month consulting engagement, auditing their previous invoices and identifying items that had been missed. The results of this engagement led to their becoming an ongoing user of our SMART LABORATORY BILLING solution. The practice went from not being able to cover their monthly lab bill to generating an average annual profit of $50,000 using Phytest. The actual financial benefit was much greater because the practice was also able to remove the administrative burden associated with billing, collecting and reconciling their lab invoices, saving significant staff-hours that they could then redirect towards improved patient care.
Our greatest success stories often come from clients who have attempted their own laboratory billing. The current reimbursement and payor landscape makes this challenging for practices to do successfully on their own. Our expertise, scale and proprietary tools allow us to deliver value to our clients in the form of incremental profits and reduced administrative time. By engaging Phytest, this practice was able to plug into our network to realize these benefits.
This multi-location OB/GYN group performed laboratory billing in-house and did a good job with it. But, they knew they could do better. There were certain pains in the process that resulted in the group’s administrative staff spending a disproportionate amount of their time on laboratory billing. Phytest developed a custom solution that eliminated many of the group’s manual processes, while capturing missed billings and reducing costs. The Phytest solution includes:
- An audit of the monthly lab invoice to identify and correct any pricing errors;
- An upfront monthly analysis of the projected profitability of tests performed;
- Identification and capture of CPT procedures on the lab invoice that were not billed out at time of service;
- Identification of those charges that should be transferred back to the lab for payor billing;
- Enhanced Management reporting to track key metrics across the group’s multiple locations.
At the same time, this group was able to benefit from access to the purchasing power of the Phytest network to reduce its overall cost of testing. Our client has seen an annual improvement in their bottom line of approximately $390,000. This doesn’t include the “soft” savings from reduced staff time previously spent manually reviewing lab bills.
If you are billing for your labs, we want to talk to you. Whether it’s improving your processes, implementing best practices, capturing missing revenue, reducing costs or all of the above, we can and will deliver. How can we be so sure? Our expertise, scale and proprietary tools allow us to deliver value to our clients…just like we did here.
This client wanted to transition their lab work to a new lab because the physicians believed this new lab would provide improved clinical results. At the same time, the practice wanted to ensure they were receiving market competitive financial terms.
Having worked with the new lab in other markets, Phytest was able to use its existing relationship to facilitate a winning solution for all parties. The practice was able to quickly transition their lab work to realize the clinical benefits offered by the new lab while ensuring they did not incur any adverse financial impact. The new lab was able to begin servicing their new client without any long delays created by extended financial negotiations.
Our objective is to make our clients’ clinical choice of lab work for them financially and operationally rather than the other way around. We want all of our clients to work with the lab that they feel will provide the best clinical service for their patients whether that is a national, regional, or local lab. We keep sight of the fact that ensuring patients get the best quality care is what it is all about. This is just one example of how we support our clients in making that happen.
Some people think our service is only for large practices, but that’s not necessarily true. The client has 2 practicing physicians and 1 physician assistant, and were interested in billing for lab services. They knew they faced a challenge, not only in getting market competitive terms, but also in absorbing the additional work involved in billing for lab services.
By engaging Phytest this group was able to solve both problems. They were able to benefit from the purchasing power and begin realizing an annual return of approximately $20,000 from efficiencies in laboratory billing without incurring the additional internal expense.
Our extensive network gives us the opportunity to help physician practices that would ordinarily not have the opportunity to successfully bill for lab services. Each new physician and new physician practice benefits the aggregate group, which has the downstream impact of allowing more patients access to our competitive pricing and dedicated patient service.
This multi-location, multi-specialty, hospital-affiliated group has a highly advanced and organized central business office. With 115 physicians within a 75 mile radius, the CBO efficiently handled high volumes of work. However, they were losing money on their lab billing:
- They were billing tests for where cost of testing exceeded reimbursement.
- They were unable to keep up with the management of their extremely large monthly lab invoice. This meant credits owed to them were never applied.
- They did not have time for follow up on lower dollar laboratory claims because they had so many other services to follow up on.
- They were paying for testing on services that were never properly reimbursed.
Phytest was engaged to provide a turnkey lab revenue cycle management solution. Phytest was able to address all of the issues detailed above, while freeing up time for staff at the CBO to work on their core priorities. Our proprietary tools and best practices ensured they no longer billed any tests that left them “upside down”, that all credits were posted accurately and in a timely manner and that each test was priced accurately from the lab. Most importantly their lab claims, which settled at the bottom of their priority list, are at the top of ours. By engaging Phytest, this group added an extra $10,000 per physician annually to their bottom line.