Top 4 Challenges in Genomic Lab Billing Services

Genomic labs are clinical testing facilities that analyze individuals’ genomes. The techniques used by these laboratories to study genetic makeup are constantly evolving.

As new techniques and procedures are being approved on a regular basis, coding and billing regulations get updated frequently too.

Besides these common challenges in genomic lab billing operations, there are other billing issues that plague genomic labs and impact their ability to realize revenues on time.

However, these challenges can be easily overcome with the help of a simple and streamlined billing workflow that is specific to genomic laboratories.

So, to help genomic labs understand these billing challenges and find solutions to avoid them, we will discuss the top 4 challenges in genomic lab billing processes.

1) Complex coding requirements

Coding guidelines for genomic tests and procedures lack specificity. Also, these procedures are new and so their codes also keep getting updated from time to time. This lack of specific guidelines and the constantly changing rules make billing and coding operations at genomic labs more prone to errors.

2) Lack of clarity around reimbursements

Genomic tests have limited insurance coverage. Their coverage policies also differ from insurer to insurer, making reimbursement recovery for genomic procedures uncertain.

4) Bundled services:

Many insurers require some genetic tests to be bundled under one code. Procedures that are grouped and coded receive lower reimbursement than procedures that are coded separately.

5) Prior authorization requirements:

The majority of the genomic tests require prior authorization. If pre authorization is not processed on time, it can lead to care delays and billing lags. This is yet another billing challenge that is commonly encountered by genomic labs.

Overcome Genomic Lab Billing Problems with Sunknowledge

Genomic labs have gained popularity after the COVID-19 pandemic. Their services help understand the genetic basis behind diseases and help physicians come up with solutions to get rid of those diseases. But due to constantly changing guidelines, keeping up with changes becomes very difficult

Sunknowledge Services Inc., a HIPAA-compliant healthcare revenue cycle management company, has helped numerous genomic labs all over the US overcome their billing issues. Our comprehensive and organized SOPs and workflows are case-specific, allowing genomic labs’ medical billers to quickly access relevant information and process bills as soon as possible.

We also assign certified and experienced medical billers to all healthcare providers and give them access to regular workshops and training sessions to keep them updated about changing policies and guidelines.

To learn more about our genomic lab billing best practices or start your free trial, please contact Sunknowledge.