We are living in unprecedented times calling for unprecedented interventions and unbridled focus. We wish everyone receiving this newsletter good health and energy to take care of yourselves, your families, your colleagues and your communities.

It’s no secret that laboratories are on the frontlines in the fight against COVID-19. While laboratory services are more important now than ever, declines in volume are common themes, depending on the lab service you provide, as routine visits and elective procedures get put on hold.

Billing operations are adjusting to telework and adjusting to a new workflow. Many are noticing a need for efficiency. TELCOR RCM provides opportunities to shift your focus towards process efficiency and automation for your billing workflow.

There is Good News to be Found
TELCOR is augmenting RCM to include a new procedure type-specific for SARS-CoV-2. This enables RCM to provide targeted analytics you’ll need for reporting for government programs or to provide proof of impact to your business if applying for a Small Business Administration (SBA) loan.

The CARES Act also provides welcome relief to laboratories:

  • The Medicare sequester is lifted beginning May 1st to December 31st .
  • CLFS payment rates are frozen for 2021.
  • Many business provisions are available (loans, grants, etc.).
  • Collection fees for COVID-19 have increased.

Automate, Automate, Automate
For the front end of your laboratory revenue cycle, the name of the game is quickly and easily filling in the blanks for billing information and getting claims submitted with current payer information. With the right RCM tools, you can transition from manual efforts to automation and:

  • Optimize rules that request this information for online fulfillment by your clients. This simplifies obtaining missing billing information, prior authorization or medical records from your customers.
  • Deploy 270/271 benefits eligibility to ensure current and correct payer information and reduce coverage denials.
  • Evaluate the workflow used by your remote workforce. You may need to organize their work differently based on the situation. TELCOR RCM makes this easy with workqueue views you can tailor to fit your needs.

Shifting focus to the back end of the billing process, is your team effectively monitoring open claims and conducting timely follow up? These are key components for keeping accounts receivables in check.

  • Configure 277 claim acknowledgment responses and automate claim disposition for rejections days in advance of an ERA or EOB reducing the time elapsed for your team to follow-up.
    Eliminate write-offs by tracking no-response claims ensuring no claims slip through the cracks for timely filing.
  • Fully automate claim next steps based on payer advice coding and route balances for appeal to secondary payer or to the patient with no manual intervention.
  • Build out appeal letters, appeal packages and use integrated Document Management for total automation of your claim appeal process to reduce costs and maximize reimbursement.

Dig In and Resolve Older AR
Every laboratory has aging AR requiring investigation as to why it remains unpaid. Do you have the visibility to identify and evaluate older balances or identify trends? RCM provides visibility needed to:

  • Review balances no longer collectible and deploy automation to transfer these balances to bad debt or write-off them off.
  • Classify claims and assign the work to specific teams or team members to take specific action (appeal, correct and resubmit, or balance bill).
  • Utilize advanced RCM analytics to expose payment trends and denials by payer and advice code then using that information to make rules-based changes in pre-submission process to eliminate future issues.
  • Configure patient communications using account letters or statement messages to notify them what the payer paid, what their liability is and payment terms.
  • If compliant, offer discounting options to incentivize quick patient payment.
  • Leverage patient installment agreements and offer multiple channels for patients to remit payment, which is especially important now with the current spike in unemployment.

Build Out an Effective Productivity Matrix
Knowing what your team is doing doesn’t need to be a mystery. Tracking work events of a remote workforce across the revenue cycle is now even more valuable.

  • Use this time to establish productivity benchmarks.
  • Build out your weighted values and measure the big picture.
  • When you know how teams are performing, success is obvious as are areas needing improvement.
  • Consider the importance of collaboration with other laboratories and use the TELCOR Discussion Board to share and exchange ideas.

At the End of the Day
Combined with the automation, visibility and efficiencies of TELCOR RCM, you can seize the moment and weather the storm. When the dust settles, you’ll be ready to rebound and set the bar higher.

TELCOR is here for you. Our service team is taking calls, responding to emails and logging service cases. If you have any questions—from how to do something in the application, how to set up a remote worker, how TELCOR is responding to this pandemic situation—please do not hesitate to ask.

Kurt Matthes, vice president, RCM reengineering and service, has more than 30 years of experience in laboratory systems. Since joining TELCOR in 2007, he has served in various roles, including RCM implementations, customer service and sales support, working with TELCOR customers to help ensure success.