What billing systems need to succeed
receivable system survey
receivable system that handles only straightforward billing and
accounts receivables is behind the eight ball in today’s marketplace.
pressures on test reimbursement, lab managers need to be able to
monitor key indicators, such as days outstanding by payer, profitability
by provider, and other management data that are critical to a successful
laboratory business operation. The ability to nimbly manage the
revenue cycle is becoming a major factor in maximizing cash flows
and reducing write-offs. As a growing number of large organizations
implement core laboratories that serve multiple operations, systems
also need to address the needs of multi-company and multi-facility
billing. Features that assist the claims-management process, such
as automated eligibility checking, access to skip-tracing databases,
and in-house collection agency processing, are worthwhile.
It is imperative
that systems provide clean claims the first time. It costs an average
of $25 to process a re-bill to a third-party payer, according to
the Medical Group Management Association. In many cases, this represents
more than the profitability of the billed item. And in 2002, the
Medicare program recovered $1.5 billion in fraudulent claims, highlighting
why strict compliance regulations to reduce fraud are forcing health
care organizations to better manage their claims submission processes.
that include federal and local payer edits are now part of many
systems. Some vendors also contract with third parties, such as
Info-X, for updates to the rules, saving billing offices countless
hours spent maintaining their own rules sets. A few vendors even
provide tables update services that hospitals or labs can contract
At least four
billing/accounts receivable system vendors—Antek HealthWare,
Cerner, Medical Data Processing, and Xifin—are now offering
their entire product under an application service provider arrangement.
These vendors provide service on a per transaction basis and operate
a centralized server over the Internet.
billing systems, ask vendors to share measurable benefits that can
be achieved with their system and to provide a projected return
on investment. Effective measurements include percentage reductions
in denials, re-bills, days sales outstanding, manual payment posting,
collection ratios, error rates, and other direct cost reductions.
And visit user sites armed with objectives and checklists. In addition
to focusing on features and functions, assess ease of use and productivity.
highlights 15 products in its 2003
billing/accounts receivable system survey. The tables are based
on information provided entirely by the vendors. We urge readers
to verify all information pertinent to them before making a purchasing
decision. Be aware that because a vendor indicates that it has a
feature installed in 100 percent of its customer sites does not
mean that any of those sites are operating the feature, assuring
Be sure to ask
questions that provide a “big picture” of the vendor,
such as, How much money is being spent on research and development
and new product upgrades? When was the last major product release,
and when is the next one planned? How many new contracts were signed
in the past year? Has there been a net increase or decrease in your
installed base of billing systems?
New to this
year’s survey is Tamtron, which introduced a billing module
for its PowerPath anatomic pathology system in 2002. SIA, which
was featured in previous CAP TODAY billing surveys, declined
to participate this year.
Weiner is president of Weiner Consulting Services, LLC, Florence,
Ore. He can be reached at firstname.lastname@example.org.