Revenue Cycle Management

Hospital and independent laboratories are facing tremendous reimbursement pressures from both federal and private payers. Compliantly collecting every dollar due your lab is of the highest priority and the management of your revenue cycle is a good first step. NMG has extensive experience in bringing improved revenue cycle management that can lead to increased cash collections.

In this competitive environment, laboratories are presented with new and unique marketplaces, practice patterns, reimbursement and compliance issues. NMG assists clients in managing these financial uncertainties, position them for a successful future. Balancing fiscal, strategic and operational initiatives, we provide support and assistance with development of your revenue cycle implementation plan.

It is important to know that national spending on clinical lab testing services, including anatomic pathology, is expected to decline about 0.1% per year between 2018 and 2020. Overall, laboratories can expect to see their Medicare payment rates for most high-volume tests to decline about 30% between 2018 and 2020.

Some private insurers have already begun to lower their clinical lab test reimbursement as a result of reductions to the Medicare Clinical Laboratory Fee Schedule. Payers and organizations have an interested in pursuing third-party billing for esoteric and higher cost reference lab testing sent from their organizations to limit the financial burden on organizations for this type of testing as well as to obtain transparency into utilization of new testing technologies.

NMG can assist your laboratory by performing an audit that will focus on analyzing the workflow and efficiency of laboratory billing, contracting and revenue collections. We will identify areas of potential optimization and provide recommendations for overall profit maximization.

Our financial consultants provide hospitals and health systems consolidated and individual laboratory financial statements to identify lab profitability as well as immediate areas of improvement.