As a clinical laboratory, you probably feel like you’ve been under siege lately. Increased oversight and audits, rising operating costs, and falling reimbursement rates have created an uphill financial battle for clinical labs. And many are struggling to survive, especially in a highly competitive market with a lot of client turnover. Now, more than ever, it’s critical to tighten up the documentation and clinical lab billing processes to ensure you are recovering costs.
Many labs felt an initial shock wave in 2014 when the Protecting Access to Medicare Act (PAMA) was signed into law, and again in 2018 when new payment rates became effective. But with additional restrictions and reporting requirements, as well as deeper PAMA payment cuts on the horizon, clinical labs are bracing for the full impact. For many small and medium labs, it will prove difficult to make a profit, and some may struggle to break even. This is especially true when you consider the existing challenge of obtaining insurance contracts and receiving appropriate reimbursement. Narrowing insurance payments and issues collecting patient payments only make matters worse.