Laboratory revenue cycle management in a non-post-pandemic world

October 22, 2021

By: Mick Raich, President, RCM Consulting, Lighthouse Lab Services / Vachette Pathology

Cell: 517-403-0763

I heard the phrase “post pandemic” this week and thought to myself, “Are we ever going to be in a post-pandemic state, or has the world changed?” As I have said all along, things seen cannot be unseen. I think we are going to be living in a Covid world going forward. 

Look at all that has changed in the last 24 months: We have vaccines, mandates, unemployment issues, supply chain problems, further division of our society and a state’s rights versus federal rights battle. All of this is backed by the two-party social media hyperbole feeding frenzy. But change is life huh?

Our current state

So, in this non-post-pandemic state, how do we function in the laboratory revenue cycle management (RCM) world? Things are different, huh? First and foremost, the employment issue is a real problem.  Many billing companies are struggling to keep qualified employees and this may even get worse when the vaccine mandate becomes law. It’s likely 3%-5% of people are going to retire or look for other avenues of employment instead of following the mandate.

Tie into this an aging workforce, and now you have your accounts receivable going up because no one can work the claims. The logical next step is to offshore this work to a country with different work requirements and a large underemployed work force. These emerging markets will likely be the backbone of billing by 2031. 

The next issue for the lab RCM world will likely be tied to HIPPA compliance. As the cyberworld grows, so do cyber-attacks. If banks and hospitals and the Pentagon can get hacked in America, imagine the drama that comes from a HIPPA breach in Senegal? You can argue AI will make this more manageable, but this is another factor which increases medical cyber risk. 

Preparing for this new reality

The future is now. So, what to do next? You cannot keep doing the same thing and expect different results, and you likely aren’t going to live in a Covid-free zone, so you have to learn to handle the dramas coming your way. 

Could there be several answers moving forward? For one, you should invest in rock-solid cyber prevention. You can’t rely on simple out-of-the-box solutions. It is my thought many companies will build and hire a cyber compliance force over the next few years. This force will be augmented by an in-house automation engineering team. Automation must be increased in the RCM world. The cost of handling any claims by hand will no longer be feasible. There are numerous AI companies pushing billing add-on programs which will help elevate some backlogs. The next logical step is a totally automated 100% human-free billing process. Will customers be willing to accept this change? 

In summary, like the Permian Triassic Extinction, are we looking at the end of some of these businesses and processes? Will we, twenty years from now, look back at the old ways and say, “Remember when we started the Post-Pandemic Period?” 

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