Automated Demographic Verification – Why All Laboratories Should Implement it?


After a patient visits their doctor, it is often required to run a few biological tests. And while patients provide the doctor’s office with sufficient information about their insurance and demographic, laboratories often don’t get the same treatment. You see, many patients come without their Medicare card or health insurance information.

As a result, laboratories must reach out to the clinic or hospital to receive the patient billing information. Consequently, the laboratories are at risk of collecting poor information about the payer, leaving patients without proper billing by their insurance. This can also negatively impact the billing and reimbursement process.

With the downward pricing pattern of labs, the workers at these facilities are facing money problems. This is why it’s more important than ever to receive payment on all earned revenue.

In this article, we will cover the benefits of automated demographic verification (ADV) tools and their role in increasing payment flow to laboratories.

The role of automated demographic in payment processing

The number one reason behind denied claims is faulty patient demographic information. A single mistake in patient demographic data can lead to weeks of delayed claim payment.

Fortunately, automated demographic verification ensures the smooth processing of data and the swift billing of patients. To prevent revenue leakage, a laboratory should prioritize the accuracy of patient information.

Once achieved, processing claims becomes much easier, and the risk of delayed reimbursement significantly drops.

What are the benefits of automatic demographic verification?

ADV tools analyze the provided information to check for its accuracy. Some of the elements that can get verified with an ADV tool include:

  • Patient name
  • Date of birth
  • Current address
  • Previous address(es)
  • Current phone number(s)
  • Social security number

By locating the missing information, you will improve the discovery hit rates. Billers can also obtain comprehensive and accurate information for patients and claims easily and effectively.

Some of the benefits that you can reap from automated demographic verification tools are:

  • A drop in operational expenses
  • Statement delivery rates improve significantly
  • A reduction in the number of payment delays
  • A reduction in the number of claim rejections
  • Lower risk of HIPAA compliance errors

ADV removes the burden placed on administrative workers in laboratories. The staff can easily capture, discover, and verify patient information. The whole process is done automatically.

With this technology, a few seconds is all it takes to find and vet patient data. Manually, this would cost several precious minutes per patient. Your administrative staff will no longer have to spend hours on the phone with provider offices or patients to collect the missing data.

The added benefits of using multiple technologies together

Laboratories can benefit greatly from the technology of ADV. This process lowers the risk of errors and alleviates the burden on administrative workers. You will achieve operational efficiency, faster reimbursement, and streamlined workflow. What’s not to like?

You will come across two types of ADV tools. The first can is a separate tool that processes patient information. The second is part of a real-time accounts receivable optimization (AR) tool. To optimize your billing process and expedite payments, make sure to use the second type as it provides a more comprehensive view.

Insurance discovery tools help with:

  • Delivering accurate data
  • Revealing hidden coverage (some are billable)
  • Driving deductible conversions

Aside from that, integrated technologies in automated demographic verification provide you with deducible monitoring, claim monitoring, and automated self-pay analysis. The latter is useful to identify patients that would pay and those who need hardship discounts.

As for deductible monitoring, it allows revenue cycle professionals to issue claims accurately and increases the chances of proper reimbursement. It also lowers self-pay collection costs.

Laboratory staff will also learn about claims’ status without the need to contact payers. This is thanks to automated claim monitoring. The final result is lower collection agency expenses and higher self-pay conversion rates.

Applying ADV renders lab billing way more efficient and prevents revenue loss due to:

  • Rejected claims
  • Collection agency fees
  • Bad debt write-offs

Make sure to use this technology with other AR optimization tools to benefit from increased self-pay conversion rates, more revenue, and reduced staffing costs.

Takeaway message

Automated demographic verification tools should be prioritized in every laboratory to face the financial challenges that we are seeing today. This process improves the collection and verification of patient information and reduces the risk of claim rejections.

We hope that this article managed to highlight the role of automated demographic verification tools in managing the financial side of laboratory work.