Overview
Accurate patient demographics and insurance data is a leading cause of claim denials, leading to delays in billing and payment for laboratories.
Automated demographic verification (AV) technology enables laboratories to reduce their claims rejection rate and protect against revenue losses caused by denied, reworked, or rejected reimbursement claims.
1. Reduced Errors
Correct patient demographic and insurance information is often the source of claim denials in laboratories, leading to delays in billing and ultimately decreasing revenue for them. Automated demographic verification and prior authorization solutions can ensure accurate data entry while increasing revenue capture for labs.
Laboratories can leverage demographic data to gain a better understanding of who lives in any particular community or area and develop marketing strategies accordingly. They can also make more informed decisions regarding product inventory and placement decisions. Demographics data can also help laboratories target specific groups such as women,
older adults or families.
Research laboratories often face unique challenges that distinguish them from industrial or clinical labs, such as difficulty justifying investment in automation equipment based on cost-to-turnaround time metrics that commercial labs can easily apply. Instead, research laboratory managers seeking funding approval must convince funding bodies that the equipment will increase research output by an undefined number of “experimental results” (Archetti et al. 2017).
Automating research laboratory processes not only reduce costs and turnaround times, but they can also benefit by improving their results’ quality. This can be accomplished via data processing/reduction automation or through using more precise measurement instruments; additionally, increasing automation processes reduces human error introduced into a laboratory environment.
Research labs may opt to build their own laboratory automation, which is both expensive and time consuming. However, more vendors now provide cost-effective automation equipment suitable for research facilities. Automation allows laboratories to implement it in areas that have high repeatability, such as liquid handling. Such automation can drastically decrease manual labour in laboratories. Investment in automation solutions is therefore worthwhile for many
research labs, yet researchers should be wary of committing solely to one supplier for an entire automation project, as this can create price instability and long-term supply risk should they go out of business.
2. Increased Revenue
As patient deductibles continue to increase, laboratories need to verify insurance and benefits quickly in order to collect appropriate copays or coinsurances at the time of service. Automating demographic verification can make an immense difference to many labs’ revenue cycles by eliminating denials and improving cash flow.
Before embarking on any automated demographic verification strategy, laboratories should set clear goals for their lab team in order to secure buy-in from across their organization. When setting goals for automated demographic verification systems, laboratories should think about what their objectives are in introducing this technology and how this might influence business. Possible goals might include cutting waste in their laboratories while improving staff retention or providing lab workers with more productive and stimulating tasks every day.
Lab automation in life sciences research continues to become more and more popular among researchers, and several institutions have started developing
homegrown laboratory equipment in an attempt to cut costs, increase efficiency and streamline workflow. Unfortunately, many systems designed by manufacturers only operate when used with specific consumables from them – pipette tips for Opentrons/Tecan EVO liquid dispensing systems or array tapes for Douglas Scientific’s IntelliQube PCR system or purification cards from Invitrogen benchpro and Qiagen Qiacube systems respectively – thus restricting their wider adoption in other laboratories and potentially hindering wider adoption of technologies.
Demographic data provides a more in-depth examination of population movements over a geographical area, and can also help inform social media strategies and mobile location based marketing based on what types of people live nearby.
Increased lab automation is widely recognized as a crucial strategy for economic advancement and innovation, particularly within publicly funded academic settings where access to more sophisticated equipment allows laboratories to go beyond experimentation to clinical usage and generate valuable revenues. Therefore, governments should offer competitive schemes targeted specifically towards increasing lab automation to bridge the gap between laboratory bench and hospital bedside.
3. Reduced Administrative Burden
Laboratories serve a vital function in healthcare: testing patient specimens for various medical conditions. Unfortunately, labs are often not the initial stop in a patient’s healthcare journey and often rely on doctors and hospitals for patient information such as insurance information to receive patient demographics for billing and reimbursement processes. Missing or inaccurate demographic data hinders this process; having accurate data in hand of revenue cycle teams ensures a smooth process – automated demographic verification tools make this easy.
The COVID-19 pandemic has increased laboratory scrutiny as never before, prompting them to find ways of decreasing unnecessary manual processes and increasing efficiency to meet demand while maintaining patient safety and test quality. While much work remains, one area which could see immediate gains are in laboratory pre-billing and insurance verification processes.
While investing in laboratory automation equipment makes a compelling business case (Klaus and del Alamo, 2018), research laboratories may not be in a similar financial position when making such financial decisions as industrial factories do (Ceroni 2009). Output from research labs may be measured through scientific discoveries or publications while factory output might be measured through profits generated per hour of operation (Ceroni, 2009), making the
difference between them all the more apparent – something which may prevent investment into laboratory automation systems.
Establishing a system to automate a specific protocol requires time and capital investments that may prove challenging in labs operating under short duration research funding schemes, where researchers’ work is limited by project contracts. Such short term positions do not afford researchers enough time for developing an idea for laboratory automation into a fully operational solution.
Employing a reliable automated patient demographic verification tool helps laboratories of all sizes maximize revenue while improving operational efficiency. When used alongside real-time accounts receivable optimization tools, demographic verification technology accelerates and simplifies pre-billing while protecting against preventable revenue losses through rejected claims, collection agency fees, or bad debt write-offs.
4. Increased Patient Satisfaction
Demographic verification tools are designed to address this problem by reducing inaccurate demographic data that’s usually caused by data entry errors or human oversights, and prevent them from ever happening again – saving both labs and patients money by eliminating rejected claims, collection agency fees and bad debt write-offs altogether.
Laboratories have always faced the delicate balancing act between accurate testing results and patient privacy, and demographic verification tools that help ensure correct information is entered for every test order. Automated demographic verification tools provide your laboratory with an efficient way of doing just this; using automated demographic verification tools helps your lab save both time and money by reducing rejected claims; this increases staff productivity while simultaneously increasing patient satisfaction.
No matter whether it’s clinical or research lab management, finding ways to increase efficiency while protecting patient safety is an ongoing challenge. Staffing issues during periods of pandemic or other high-demand situations exacerbate this difficulty further, while laboratory automation solutions could be an ideal way to address such challenges by helping the lab complete more tests in less time.
One effective strategy to reap the full advantages of automated verification is by engaging your staff at every stage. Acquiring their insight on which workflows should be automated and where equipment should be placed are all essential steps of this process and will reduce the chance that employees feel threatened by machines taking over their roles, helping smooth their transition process.
While a clinical laboratory manager can easily argue the benefits of laboratory automation on cost and
quantifiable output of turnaround times, a research laboratory often struggles to convince funding organizations that investing in automation will enhance reproducibility in research results.
When the time comes for your laboratory to implement automated demographic verification, keep in mind that there are various tools to choose from that fit the unique requirements and needs of your lab. Understand all potential advantages this technology may bring such as improved workflows, operational efficiencies and revenue increases.
