Our Service: Automated Clinical Documentation to maximize revenue
Don’t throw more people at the problem. Automate.
Cellarian provides intelligent process automation to clinical documentation, prior authorizations, and denials management to help our clients maximize available revenue capture and decrease the administrative burden for diagnostic labs and their physician customers.
Lack of Medical Necessity Documentation is the Most Preventable Cause of Revenue Loss
Labs write off millions of dollars annually.
Drug testing is now a high-volume, low-dollar service. Providers are too overwhelmed to adequately document a patient’s medical necessity reasons for every test ordered. Yet, without this documentation, the revenue is unreachable.
The Challenges
A solution is needed to intelligently automate clinical documentation processes, stay up to date on changes in payer medical necessity and reimbursement guidelines, and accelerate the time from claim denial to successful payment.
Insurance payers overload doctors with excessive medical necessity documentation requirements as a strategy to deny payment for services.
Laboratory Benefit Management process automation by payers uses denials to drive lab behavior towards low-reimbursement codes, since Labs need doctors to provide proper clinical documentation to get paid.
Doctors don’t perceive benefit from the cost of adding clinical documentation, so they rarely do it, resulting in denied payments and significant revenue loss that labs cannot recover without documentation.
Denied claims are expensive to appeal, so labs are forced to either write off on average 20% of monthly accounts receivable or spend more money/staff resources trying to fight the denials which are often never paid due to lack of documentation. These additional expenses further decrease monthly net profits.
The Cellarian Solution
Using data sources such as Laboratory Information Systems and Electronic Health Records, Cellarian automates patient-specific clinical documentation, claim appeals, and prior authorizations to help labs reduce denial management costs, streamline operational efficiency, and collect more revenue so they can focus on growth, without adding any work on doctors and remaining in compliance with HIPAA regulations.
By automatically searching and integrating updated payer medical necessity policies Cellarian ensures maximum revenue capture and compliance with payer guidelines, matching the payers’ Laboratory Benefit Management and ensuring the maximum reimbursement compliantly allowed.
Our scalable technology platform is rapidly adaptable to any diagnostic lab service line with clinical documentation requirements, increasing claim denials, or time-consuming prior authorizations, with the greatest ROI delivered at scale.
Benefits
Higher Monthly Cash Collection
Our solution delivers the necessary documentation to reverse denied claims and prevent rejection of prior authorizations.
Higher Average Reimbursement per Claim
There’s no reason to down-code with Cellarian’s medical necessity documentation. Labs collect more per claim, decrease risk, and stay compliant.
Faster Claim Appeal Process
Cellarian Automation shrinks the appeal process from weeks to minutes, which means improved cash flow and operational efficiency.
Cellarian delivers the medical necessity documentation you need to support claims
Cellarian is the first-to-market SaaS-model software solution that creates patient-specific, compliant medical necessity and appeals documentation along with intelligent process automation to increase revenue, improve efficiency, and decrease risk.
Other companies only tell you what’s missing.
Cellarian actually creates it. Compliantly.
Cellarian is Transformative.
Cellarian is the only Company that compliantly creates clinical documentation needed for payment, without adding more work on doctors.
Cellarian is Smart.
Designed by physician and drug testing specialists, along with revenue cycle and compliance experts. AI-driven processes automatically update payer medical necessity policies to ensure maximum revenue capture and compliance with payer guidelines.
Cellarian is Expandable.
Modular software design is rapidly adaptable to any diagnostic lab service line with clinical documentation requirements, increasing claim denials, or time-consuming prior authorizations, with the greatest ROI delivered at scale.
Cellarian plays well with others.
Our automated solution integrates with EHR's and Lab Information Systems and can even be integrated into other RCM products to improve their suite of services.
