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MAXIMIZE PATHOLOGY GROUP REVENUE WITH EFFECTIVE CLINICAL PRO FEE (CPC) BILLING

January 18, 2019

path 1Many pathology groups are missing out on potential revenue as a result of inefficient and ineffective processes. Most groups fail to evaluate their billing practices and results regularly which results in missed revenue opportunities.

 

Here are 5 tips to help ensure your group is maximizing revenue.

  1. Stay on top of hospital charge master to make sure all potentially billable codes are included in pathology group’s CPC billing.
  1. At least once a year open the floodgates for all CPC billing by sending charges to ALL payers, except DRG-related payment or non-paying governmental payers, to make sure you are not missing any payers which are paying and/or to account for shifts in payer mix.
  1. Increase the fee schedule 4-7% at least a year.
  1. Though you never want to send CPC claims to collections for patients or payers, assertive billing practices with high-ticket follow-up to patients will yield more dollars.
  1. Never assume you’re getting all that you can get for CPC billing.  You have to manage it rather than “set it and forget it”.

As we all are aware, reimbursement and insurance guidelines are ever-changing. In order to ensure your group is not missing revenue opportunities, it’s key to stay on top of CPC billing to ensure your group is maximizing revenue potential. 

For more information on our pathology revenue cycle solutions or to schedule a free assessment, click below.

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