Billing complexity remains so without a process

ABOUT

The client is a rapidly growing pathology lab in California with physician practices as its clients. Our client gets paid based on lab samples analyzed for those physician practices.

CHALLENGES

The client entered into various agreements with physician practices (its clients) that impacted how billing was executed. Some required global billing, some required professional billing with specific modifiers, some others required that the end clients bill themselves while the lab would submit invoices to the practices later.

WHAT WE DID

We first understood and documented the various requirements that each end client had. This helped us establish a repeatable process around global billing, technical component billing with specific modifiers, insurance specific billing, end client reporting and invoicing methods.

LIFE WITH NEXTSERVICES

Complexity remains so only when a process is not established. Our team works with clients to help them simplify systems that ensure relentless repeatability. This helps clients reduce the risk of uncertainty and gives them the flexibility to take on the challenges of growth.