| Chairing a Pathology Department at Centrastate | | | | distribution of Accounts Receivable. A |
| Hospital in New Jersey and simultaneously running | | | | well-performing service will have half of the claims |
| two laboratories in two remote states (Oklahoma | | | | paid within 15 days, with over 90% of all claims |
| and New Jersey) require Dr. Michael McGinnis to | | | | being paid within 45 days. The narrower |
| match his medical expertise with savvy business | | | | "bell-curve" of Accounts Receivable means better |
| sense. | | | | cash flow predictability while its lower "tail" means |
| "A pathologist must track workflow of the entire | | | | added revenue. |
| laboratory from receiving a sample and requisition | | | | Software-as-a-Service (SaaS) |
| form, to accessioning, to patient demographics, to | | | | "Gone are the disk crashes and software |
| history, to gross, dictation, proof, distribution, and | | | | maintenance. No more office staff moods and |
| billing," says Dr. McGinnis. "I need to know | | | | conflicts to resolve or benefits to pay. I now pay |
| precisely what unfinished work is left at each | | | | only for performance, which makes perfect |
| stage in every lab. I need to track every step | | | | business sense," says Dr. McGinnis. "Finally, I can |
| and know exactly who has done what regardless | | | | replace my administrative assistants with medical |
| of their location. And I need this information in real | | | | specialists that can take over some of my |
| time. For instance, I need the list of signed off | | | | workload and add revenue." |
| reports arranged by requesting doctor, date, | | | | Mission-Critical System Features |
| patient, or payer, in real time." | | | | The following seven features are critical for |
| Information Systems Challenges in a Pathology | | | | accomplishing the benefits listed above: |
| Laboratory | | | | |
| Pathology billing is especially complicated because it | | | | 1. Comprehensive integrated functionality covering |
| requires: | | | | entire laboratory workflow |
| | | | 2. Internet-based access to data entry and |
| 1. Data flowing between | | | | reporting |
| 2. Hospital system, | | | | 3. An interface between hospital internal system |
| 3. Multiple requesting doctors, | | | | and external billing service |
| 4. Internal laboratory system, | | | | 4. Arbitrary aggregation and comprehensive |
| 5. External billing service, and | | | | analysis of all laboratory and billing data |
| 6. Multiple insurance companies | | | | 5. Full and transparent access to each and every |
| A system of checks and balances to | | | | claim, from accession number to coding to |
| 1. Prevent losing a case | | | | payment |
| 2. Ensure full and timely payment | | | | 6. 24x7 status reports about received payments, |
| Continuous Measurement | | | | submitted claims, rejections, follow-ups, and delays |
| Billing quality is best understood by observing the | | | | 7. HIPAA compliance. |