Why Hospital Out-Patient Diagnostic Billing?
The Government is continuing to restrict independent clinical labs due to recurring compliance and quality issues. Payers are strategically making moves to block all but a chosen few clinical labs by restricting in-network access. This forces out-of-network labs to strategically align themselves with health systems in order to have a seat at the table. Additionally, patients, clinics, rehab groups, and MDs prefer working with higher quality lab system than their current choices dictate; That's where you come in...
Benefits of being a Preferred Partner
- 90% adjudication rate
- 50% of claims within 30 days
- Work with the top health systems in the country
- Above average reimbursement
- State-of-the-art specimen tracking system
- In-Network status for 90+% of claims
Why is this Different than other HOPD models?
- Planned and structured to meet stringent legal guidelines
- Professional execution, meeting all applicable compliance protocols
- National scope of operation and linked to a unified operational team to capitalize on team strengths
- We have been engaged to represent the hospital systems so you will not be dealing with brokers and middlemen
LABORATORY PREFERRED PARTNER PROGRAM
Our ideal Preferred Partner will meet the following criteria:
- Have the ability to refer a minimum of 5,000 specimens per month
- Have been in business for at least one year
- Have a clean record and successfully complete the vetting and compliance process
- Have capacity to process additional specimens
- Have direct access to the laboratory owner without marketing groups or sales representatives
- Be CLIA, CAP, or COLA certified and have successfully passed an inspection within the last 2 years
- Toxicology Quantitative Method capable of testing 60+ analytes
- Be able to complete a 48 hour turnaround time from receipt of specimen to reporting of certified results
OUR REIMBURSEMENT TIERS
- Tier 1: Per reimbursable confirmation specimen (97+% clean claims)
- Tier 2: Per reimbursable confirmation specimen (94+% clean claims)
- Tier 3: Per reimbursable confirmation specimen (90+% clean claims)
