Four Tips Your Pathology Practice Should Consider Before Switching Medical Billing Companies

New technologies have significantly improved administrative tasks yet many pathology practices today still rely on manual processes that cause administrative strain and employee turnover. Retaining and recruiting non-clerical staff is difficult and can be expensive. In the US, the average cost of hiring a new employee is $4,425. In healthcare, this cost can easily exceed 30 percent of the annual salary for the position.

Or perhaps you currently outsource your medical billing but are unhappy with your pathology medical billing vendor. Aside from the obvious cost considerations or low reconciliation rates, organizations often leave their current billing company due to non-monetary reasons such as compliance issues, poor patient experience, lack of vigilance, or failure to provide reports to clients. Before making a switch, it is important to do your due diligence to find a partner that fits with your organization and delivers on reconciling old claims in a fair and efficient manner.

Here are four points to consider before your pathology practice switches billing companies:  

1. Make sure they’re in compliance with regulations. 

Pathology billing must comply with various regulations, including HIPAA, OIG, and CMS guidelines. Non-compliance can lead to fines and legal consequences.

2. Confirm they know proper reimbursement rates. 

Reimbursement rates for pathology services can vary widely depending on the payer and the specific service provided. It is important to understand the different reimbursement rates and negotiate contracts with payers to ensure fair reimbursement.

3. Ask about their process to avoid billing errors.

Billing errors, such as duplicate claims or incorrect coding, can lead to claim denials or delays in payment. It is important to have effective billing processes in place to minimize errors and ensure timely payment.

4. They should be on top of changes in coding and reimbursement policies.

The coding and reimbursement policies for pathology services can change frequently, requiring ongoing education and training to stay up-to-date and compliant. Overall, pathology billing requires careful attention to detail, compliance with regulations, and effective communication with payers to ensure accurate and timely reimbursement.

If you are looking to maximize or improve collections or don’t feel like your pathology practice is getting quality service, it might be time to switch your medical billing company. Pathology practices can ease the burden of change by following our four guidelines.