Financial Fitness: The Bottom Line for Lab 

Operational changes focused on increasing efficiency and decreasing expenses to protect revenue are without question--crucial in 2021. While wearing a mask reduces the risk for the most vulnerable, social distancing and hand washing are also necessary to prevent the spread of COVID-19. Similarly, protecting revenue through operational changes is simply not enough. Additional steps must be taken to protect revenue cycle business continuity.

Clinical laboratories have an opportunity to mitigate risk by simultaneously initiating an RCM audit and implementing performance improvement initiatives focused on ensuring financial fitness, compliance, and sustainability in times of great uncertainty.

What’s Next?

Healthcare organizations must become more innovative and use predictive technology to anticipate cash flow and mitigate risk, reconcile claims, protect the integrity of revenue, and proactively plan for the unknown in the days ahead.  

Nichols Management Group has partnered with hospitals and health systems across the country to implement best practices that drive measurable cost savings, improve patient care, and provide a path forward for growth. 

Let’s take a look at three key areas of financial risk that require a strategic approach to offset impact:

• Coding/Billing and Compliance

• As new information about COVID-19 becomes available, there are many new reimbursement rules and regulations that must be updated in systems and this continues to change. 
• Organizations must consider the changing landscape of healthcare to include Telehealth visits and appropriate billing for those services.
• All providers must follow and adhere to the latest coding and billing guidance from the CDC, CMS, AMA, and other official organizations. Keeping up with all of these changes is even more challenging with staffing deficiencies due to furloughs in many health systems. 
• Outsourced medical billing is an option to consider in order to mitigate the impact of rapid coding changes and staffing shortages. 

• Accounts Receivable Management

• • Hospitals and health systems may choose to implement new technology to effectively improve cash flow as patient volume fluctuations continue to be erratic. 

• • In addition to utilizing the capabilities of the EMR system, a system that monitors records in real-time would allow timely auditing and coding adjustments to cut billing turnaround and reimbursement delays.

• Bad Debt/Collections

• COVID-19 has created a “surge” in uninsured patients needing care. The result is higher levels of bad debt and collections. What strategy can be employed to maximize the opportunity for payment and/or reimbursement?

Without question, hospitals, health systems, and clinical laboratories are dealing with many real-time changes to reimbursement. Partnering with an experienced provider can ensure effective and efficient support to optimize revenue in 2020. Call us to discuss your financial fitness goals at (207) 363-8230.