setstats Genesis Pathology Billing

Standard Services

Genesis customizes its software for each pathology practice to ensure the accuracy and efficiency of all charge and patient demographic data capture. No other system achieves the level of automation provided by our software, which results from our experience of developing nationally accepted software for 25 years. Genesis maintains an encrypted VPN tunnel that allows secure transmissions between our clients and ourselves. This also gives our clients access to their financial results at the touch of a button on their computer.

A central design point for our software was the premise that all claims that could be filed electronically would be. From there, we have developed the most sophisticated claim tracking system in the industry and have backed it up with the most highly automated claims appeal functionality provided by any billing software solution from any service or vendor.

We understand that just sending a “correct” bill is not enough. The likelihood of a patient choosing not to pay in today’s managed care/contracted fee environment can be impacted dramatically by educating the patient very carefully as to why their insurance company paid what they did (and did not) and how they might get their insurance company to pick up more of the billed charge. We will continue to bill patients as long as they make a payment at least once every three statements no matter how long that may take. We rotate the use of three collection agencies, always dropping the poorest performer and replacing them with a firm we believe will provide a better result. Clients may choose to use a collection agency or not. Genesis will handle patient accounts according to the instructions of each client.

Medical questions will be redirected as designated by each client. We have found in most cases that the best solution is to direct the patient to the ordering physician (since it is their responsibility to handle this function), but our staff is trained to be sensitive to the patients level of satisfaction with the entire process and will do most anything to enhance their experience and increase the likelihood that they will pay their portion of the bill. While our data collection is extremely accurate, it is only as good as the job done by the ordering physician’s office or the hospital admission staff. All of our communications with patients are performed as though they are our customers.

Genesis is (to the best of our knowledge) the only billing service that keeps permanent online records of our client’s business from the day they migrated to our service. At both the detail patient level and the analytical totals level we can reproduce any report or information that was produced from the beginning at a moments notice. While the data is used infrequently; the ability to do trend analyses enables us to discover things that are happening over time that might otherwise be missed. A slow shift in the ratio of Tissue III’s to Tissue IV’s is an example. While clients frequently choose to receive only a few of our financial reports , they are pleased to know that there is practically no limit to the power of the Genesis System as we gather and maintain their data.

Genesis monitors each client’s financial results based on many factors including recent charge production, policy changes from major payor types, time of year and any other event that is know to impact cash receipts. When revenue is lower than expected by a significant margin (as determined by normal fluctuations) our system facilitates deeper analysis that continues to drill deeper until we discover the source(s) of funds that are lower than we would expect. Again the sophistication of our system gives us access to superior analytical tools with the result being higher revenues for our clients and their physicians.

At the end of every month we supply each client with a random sample of cases performed by each physician during the previous month. Each client chooses the number of cases per physician to be audited. The procedures we billed for and the diagnoses we used should be verified against the pathology report for that case (case number is included on the report). This will confirm that the data is entered correctly in the lab, accurately transmitted by the client and received by us, and processed by us. We continue to study the interpretations of HIPAA in order to ensure that by our client’s practices and our firm is in compliance.

Optional Services

Clients may choose to have Genesis do their monthly and annual accounting and tax returns or have us forward the required information to the accounting firm of their choice. We handle all of the details and assume full responsibility for the timeliness of all federal reporting and tax deposits. We produce the payroll and, unless otherwise directed, utilize direct deposit to deliver the funds to payee’s account. Generally, pathology practices who do not own and operate their own lab choose to have us provide these functions while those that do operate a lab handle these functions themselves or outsource them directly to another supplier.

We work with each pathology practice to develop strategies with regards to participation and non-participation in the vast array of contractual possibilities that today’s market presents. Clearly this area is simultaneously one of the most important factors in determining income and one that is also very sensitive as we balance opting out of low paying plans and risk creating logistical difficulties for referring physicians. Genesis enjoys very good success at getting most contracting entities to pay high enough rates that it is better for the practice to participate than it is to opt out.

We will track and make the correct contributions to client retirement plan(s) and file the federal returns for them, or assist in finding a firm to do that directly.

"I place a high degree of value on the personal service I get from Genesis. For over six years we have relied on them to take care of the revenue side of our practice. During that time we have established a relationship of complete trust and confidence. When issues arise, I know that I can count on them to pursue a satisfactory result in our behalf. They are always willing to get involved in any matter that affects our revenue."

Rachel H. Ross, MD
Rowan Regional Pathology Associates