Introduction
Small laboratories face a hard billing reality: many claim issues are discovered after work is complete. Diagnose is built to shift those checks earlier in the workflow so eligibility, diagnosis validity, and order quality are reviewed before testing begins.
Ensuring the Validity of Diagnosis Codes
A pivotal aspect of ensuring payment is the provision of ICD-10 codes that corroborate the tests ordered. Conducting tests based on insufficient or inaccurate diagnosis codes can create extensive post-testing work, often resulting in payment denial. Diagnose addresses this pain point by integrating a diagnosis validity check during the ordering process. This functionality cross-references the provided ICD-10 codes against an extensive ruleset of recognized LCD & NCD guidelines and any additional custom rules instituted by the laboratory. Consequently, ordering providers receive instant feedback on the adequacy of their provided ICD-10 codes from an insurance viewpoint, streamlining the entire process.
Patient Demographics: Accuracy Matters
Correct diagnosis codes are important, but they won’t help if sent to the wrong insurance company. Diagnose offers tools to nullify these issues. Most important is our integrated eligibility check. At the start of every order, users receive real-time insurance status directly from the insurance company. Additionally, Diagnose integrates with USPS to ensure the precision of Zip/City/State details. We believe in enabling your billing team to focus on appeals rather than correcting basic information that should’ve been validated from the outset.
Affordability
While there are other software options offering similar features, many treat them as add-ons, often accompanied by significant cost hikes. Diagnose is built to deliver advanced billing-focused capabilities with transparent, no-contract pricing for small laboratories. At Anima Software, our mission is to champion the success of small laboratories. We understand that an affordable system, adept at navigating billing complexities, is pivotal for a laboratory’s thriving operation.
Test Configuration
Test configuration can create downstream billing confusion when panels, reflexes, and calculated tests are not mapped clearly. Diagnose is designed to make that mapping explicit so billing teams can quickly see what was performed, how it maps to CPT, and where services were rendered.
Summary
Diagnose was created to solve the problems of the small laboratory. A harsh reality many face is getting paid for the work performed. The intricacies of today’s billing process heavily favor insurance companies. However, Diagnose is here to level the playing field, ensuring you have all the information required to achieve prompt payment without the unnecessary runaround of unchecked boxes.
Book a demo to see how Diagnose can protect your lab’s revenue.