In today’s complex laboratory reimbursement environment, even minor inefficiencies in your revenue cycle management (RCM) can lead to significant revenue leakage and compliance risk. This two-part series, RCM Gap Analysis for Laboratories, equips laboratory professionals with the skills and tools necessary to evaluate, prioritize, and resolve process gaps across the RCM continuum from patient intake through collections.
Learning Objectives
- Define the core components of a laboratory RCM gap analysis and articulate its importance in revenue protection and growth.
- Map the end-to-end laboratory RCM lifecycle and identify common vulnerabilities at each stage (e.g., scheduling, eligibility, coding, billing, and appeals).
- Apply a six-step gap-analysis methodology to assess current performance against key performance indicators (KPIs) and industry benchmarks.
- Recognize common audit areas, documentation pitfalls, and process inefficiencies that result in claim denials or payment delays.
- Implement targeted improvement strategies, including automation tools and quick-win interventions, to drive measurable improvements in denial rates, A/R aging, and net revenue.
- Evaluate the outcomes of RCM interventions using real-world data visualizations and formulate a governance plan to ensure long-term sustainability.
Using real-world case studies, interactive visual tools, and practical audit techniques, these sessions highlight how to transform reactive billing teams into proactive revenue drivers.
Whether you're managing a high-volume molecular lab, pathology group, or specialty testing provider, this course offers high-impact strategies for building a resilient, scalable, and sustainable RCM model aligned with compliance and payer expectations.
