minmax 3-3

1. Payer rejections and denials
2. Increasingly complex and stricter regulatory requirements 
3. Decreasing per-test net profit 
4. Increased industry competition 
5. Increase in lower margin testing trends
6. Labor shortage and rising labor costs

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1. Automate coding and billing
2. Reduce user error
3. Simplify and expedite billing workflow processes
4. Manage and configure workflow 
5. Maximize clean claim pass rate
6. Automate rejections, denials, and appeals processes
7. Generate executive level fiscal and statistical metric reporting and dashboards 

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ranking 1-5

1. Unify the laboratory and billing ecosystem with an integrated RCM platform.
2. Reduce denials with powerful and intelligent claim scrubbing tools.
3. Simplify and automate much of the billing workflow processes.
4. Deliver a single data entity detailing all patient/payer info, LIS, and RCM data.
5. Expanding and accommodating new testing methodologies into the billing workflow.

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1. LIS & RCM integration
2. Workflow automation
3. Operational transparency
4. Demographics validation
5. Insurance discovery and eligibility
6. Auto billing 

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1. Initial start-up cost 
2. Overall ongoing cost/unknown future cost
3. New platform learning curve 
4. Long term cost justification 
5. Per test/report fees 
6. Other

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minmax 3-3

1. Denials and rejected appeals
2. Inaccurate payments versus payer contractual agreement
3. Increased processing time due to labor shortage/staffing abilities 
4. Billing related user error 
5. Circumstantial decreases in profitable testing
6. Other

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minmax 3-3

1. Less complex and cumbersome user experience 
2. Billing and coding automation (TC/PC splitting)
3. Upfront demographic validation and insurance eligibility
4. Upfront insurance discovery
5. Automated workflow processes
6. Other

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minmax 3-3

1. Rigid platform unable to pivot to new business opportunities’ process requirements
2. Cumbersome, non-intuitive multi-siloed platform requiring excessive touchpoints to process workflow
3. Changing regulatory requirements
4. Increasing denials
5. Decreasing margins
6. Labor shortages/rising labor costs
7. Volume increase not effectively supported 
8. Increasing competition 
9. Other

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