What is Laboratory Medical Billing?

Laboratory medical billing refers to the process of invoicing and collecting payments for various laboratory services. In simple words, the tests provided by healthcare laboratories are translated into standard codes and submitted to insurance companies for the purpose of claim reimbursements. These codes are usually known as the Current Procedural Terminology (CPT) codes. These codes are recognized by insurance companies and other healthcare payers.

Digging deeper into this aspect, it can be found that the Healthcare laboratories are diverse in size and function. These are often located within or near hospital facilities. They play a crucial role in supporting physicians. This is because of the fact, they are helpful in diagnoses and the formation of treatment plans for the patients. These tests are known for their smaller contribution ranging from 3 to 5% to the total revenue of a hospital. However, it has also been observed that the findings from laboratory tests are responsible for 70 to 80% of an electronic health record (EHR) of a patient. In fact, the results of lab tests are so influential that approximately 70% of medical decisions are based on them.

By and large, it can be said that Focusing on revenue in clinical laboratories is essential because these are helpful in improving patient outcomes. It is also interesting to note that the primary contributors to lab operations are often not directly involved in the medical billing and revenue processes. In many cases, labs have a separate medical billing facility. Such tactics allow lab technicians to concentrate on their primary responsibilities. These responsibilities specifically include; managing the laboratory information system (LIS), handling procedural equipment, and maintaining a strong commitment to accurate results. This approach also enables continuous meetings with physicians and patients.

Last but not least, the unique nature of laboratory services requires a specialized approach to medical billing. It is quite different from the services provided during a hospital visit. The lab tests are billed using a set of codes known as current procedural terminology (CPT) codes. These CPT codes are responsible for the revenue cycle management and profitability of a healthcare institution. Read More...