A Proven Appeals Strategy

In recent years, laboratories across the country have been grappling with declines in revenue due to various factors including regulatory requirements, evolving payer guidelines, and a complex reimbursement system. According to StopLabCuts.org, since the Protecting Access to Medicare Act (PAMA) was enacted in 2014, 72% of tests on the Clinical Laboratory Fee Scheduled have faced payment cuts, with an additional 15% of planned payment reductions in 2024. To survive these challenging industry conditions, maximizing revenue by streamlining the appeals process is paramount to the success of every laboratory.

TELCOR Revenue Cycle Services (RCS) has established several best practices to ensure customers’ net collected revenue goals are met. Each practice capitalizes on functionality built into the TELCOR application, such as:

  • effective front-end processing rules to reduce the number of soft denials (rejections),
  • robust tools to process appeals efficiently, and
  • powerful, real-time reporting capabilities to ensure informed decision-making.

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