The field of genomics has rapidly advanced in recent years, leading to a surge in demand for comprehensive genomic lab testing services across the US. 
While this growth has revolutionized diagnostics and personalized medicine, it has also led providers to several challenges for genomic lab billing processes and keeping many worried about – how to manage the complexity in today’s highly competitive era and how to efficiently manage it all to stay afloat and maintain the profitability.   

In fact, here are a few pressing challenges faced by genomic labs in the realm of billing that one must never overlook:  

 The complexity of genomic tests – Genomic testing is an intrinsically complex affair, with a diverse array of tests that can involve the analysis of thousands of genes, each requiring specialized billing codes. The sheer number of tests and unique billing codes can make it extremely difficult for lab personnel to keep track of the correct coding and pricing information. Furthermore, the rapidly evolving nature of genomic testing and the introduction of new tests and methodologies require labs to continually update their billing knowledge which often becomes challenging and confusing for many.  

High Costs and reimbursement challenges – Genomic testing can be expensive, with some tests costing more than thousands of dollars. Payers, including insurance companies and government programs, have been slow to adapt to the high costs of genomic testing, and reimbursement policies often lag behind the current state of the science. As a result, labs can struggle to receive adequate reimbursement for the tests they perform, impacting the practice’s profitability and sustainability.  

Regulatory compliance and evolving policies – The landscape of genomic testing is continually evolving, with new regulations, codes and policies that affect billing practices. Labs must stay informed of these changes and ensure their billing processes are compliant with federal, state, and local requirements. Failure to maintain compliance can result in costly penalties, fraudulent and even jeopardize the lab’s ability to operate.  

Patient education and financial counseling – Many patients are not well-informed about the cost and benefits of genomic testing, leading to misunderstandings and reluctance to undergo testing. This lack of understanding can result in unpaid bills and increased financial strain on the lab. 

This is why it’s best to partner with an RCM expert who can help.  

Sunknowledge – the ideal RCM destination:  

Taking care of both pre and post genomic lab billing responsibility, Sunknowledge for the last 15+ years has been delivering state of art solutions to many leading genomic providers. 

Raking to the billing needs, the experts are further known for – 

  • 80 % operational cost reduction, 
  • Accuracy of 99.9 % 
  • 30% shrink in your AR bucket and even resolving old A/R as old as 90 days 
  • Fastest turnaround time and many more benefits

So what are you waiting for? Get in touch with Sunknowledge experts as Sunknowledge excels in addressing the complexity of genomic tests, reimbursement challenges, and regulatory compliance while improving your billing processes and maintaining a successful operation.