Mako Medical Laboratory
Old AR Recovery Improvement
Up to 15%
Monthly Revenue Increased by
13% to 15%
Revenue Increased by
Summary of our work
Like many labs today, Mako Medical Laboratories was struggling financially due to rising costs and payers cutting the amount they would pay for services. Medcare MSO was contracted to take over their medical billing and instituted rigorous AR collection processes and implemented a system of efficiently tracking and managing claims. With this combination, old AR recovery was improved by 15% and monthly revenue was increased by 13-15%.
Mako Labs provides a full suite of laboratory services including common tests such as urine toxicology, routine blood testing, and oral fluid testing, but also offers more advanced technology such as Polymerase Chain Reaction (PCR) and Pharmacogenetic (PGX) testing. The lab bills between two and three million dollars monthly.
Prior to turning billing over to Medcare MSO the lab had a large amount of its expected revenue held up in accounts receivable (AR) and an outdated collections system that was not working for them. On top of that, some of the government payers that had received claims were holding back payments.
The lab was dealing with:
Part of the reason Mako was losing revenue was because their coding was not up to date with the CMS toxicology coding guidelines. They were also losing a significant amount of money because they had not mastered the more complex PGX billing and coding requirements.
Medcare MSO began working with the lab by addressing old AR recovery. They then moved on to managing the laboratory billing by implementing a system designed to track and obtain maximum reimbursement for every claim.
These issues were discovered and remedied:
Medcare MSO has managed the medical billing for Mako for three and a half years with consistent results. They have audited more than 20,000 requisitions a month and recover more than $1 million in old AR annually. The overall increase in revenue since the two have been working together more than covers the cost of the service—plus the lab no longer has to staff a billing department or deal with insurers and payers.
In the years since taking on its AR and billing, Medcare MSO has helped the lab introduce new procedures such as PCR and PGX, which have brought in a lot of new revenue. Newer technologies are more suspect by payers and requirements for claims are more stringent. The MoldX enrollment process for molecular testing has to be completed before a lab can bill for any molecular claim and medical necessity worksheets and other compliance documents are required. It can be difficult to find billers who know how to manage the entire process, but it is no longer an issue for the lab because now they have a team of billers who understand the correct procedures and required documentation necessary to get these high-reimbursement claims paid.