It’s such a pleasure to have you on board as one of our esteemed sponsoring partners in the upcoming 25th Diagnostic Reimbursement Conference, December 6-7 in Boston. Can you please tell us more about your company?

With over 50 years in healthcare billing, 30 years focused on laboratories. Our laboratory business core started with reference labs and over the last 15 years have worked with some of the leading LDTs in the personalized medicine space. It’s Quadax’s unwavering commitment to collaborate with clients who benefit from our advanced revenue capture process, offering solutions to overcome challenges with test
adoption and payer coverage. Quadax software streamlines lab A/R management, boosting revenue efficiency and accuracy with customizable solutions. Additionally, Quadax developed and maintains one of the largest clearinghouses in the industry for leading clean claims performance,

What are the most common questions or challenges raised by individuals coming to find actionable solutions by working with you?

Challenge 1: Access to Actionable Analytics
Quadax’s state-of-the-art Decision and Predictive Intelligence solutions provide clients with advanced metrics to guide decision-making and prioritize claims processing. The Decision Intelligence tool offers insights through visualization software, client-specific analysis of key performance indicators (KPIs), and the capability to delve into details effortlessly. Decision Intelligence serves as a dashboard tool for data comprehension. Predictive Analytics, or Predictive Intelligence, employs machine learning to forecast
aspects such as denial predictions and strategies to prevent them.

Challenge 2: One vendor for complete revenue cycle management
Quadax engineers have developed a comprehensive Revenue Cycle Management (RCM) solution, providing clients with complete authority over claims management, reimbursement, denials, appeals, audits, and enhanced patient access. Utilizing a distinctive setup model tailored to each laboratory, clients can achieve an optimal level of control by selecting from Business Process Outsourcing (BPO), Software as a Service (SaaS), or a Hybrid model. Additionally, Quadax developed and maintains its
own clearinghouse and EDI editing engine for industry leading clean claims performance with a 99.6% first pass claim acceptance.

Challenge 3: Clean claims and prompt reimbursement is challenging without accurate patient data.
Implementing a robust Eligibility Verification product enhances clean claims and swift reimbursement. Quadax’s solution captures precise patient eligibility and benefits information, reducing the need for costly reworks and improving overall efficiency. The software retrieves benefit information at various Revenue Cycle stages, such as at the time of order and post-order and before the test result, and offers additional features like Demographic Repair, Insurance Discovery, and MBI Assist for laboratories.

Can you share with us 3 of your proudest achievements/best successes in helping your clients?

1. Quadax has successfully navigated reimbursement challenges for labs ranging from initial test commercialization to standard of care. Our scalable reimbursement operation, combining technology and a flexible workforce in a business process outsourcing (BPO) model, has effectively managed high growth.
2. Implementing a Payer Management program for a sizable LDT laboratory with a complex diagnostic test. By collaborating closely with our client, Quadax successfully advocated for changes in payers and claims processing, highlighting the test and value in patient treatment and substantially enhancing reimbursement. Leveraging our extensive industry experience, management strategies, and analytics, we achieved a notable increase in the average reimbursement per test and a reduction in days in accounts receivables.
3. A client in the oncology testing field faced a distinctive patient engagement challenge. Their patients urgently needed test results to decide the next steps in their cancer treatment. Prior authorizations were required by payers, and patients often were unaware that their physician had ordered the test amid their numerous treatments. Quadax devised a solution to conduct insurance eligibility at the time of order, gather all necessary reimbursement data, and expedite prior authorizations with payers. Additionally, patients were kept informed about the test and helped address any concerns about the test’s cost before releasing results to the physician.
These solutions significantly boosted customer satisfaction and have since been implemented for other clients.

What are you most looking forward to in the upcoming Diagnostic Reimbursement Conference?

Quadax looks forward to collaborating with policymakers and payers, gaining insights from both sides to deepen our understanding of diagnostic development. We look forward to engaging with clients, connecting with peers, fostering new relationships, and presenting on Reimbursement Operations Best Practices to collaboratively address the current challenges in reimbursement.

What are you keeping an eye on in the reimbursement landscape these days?

Quadax is actively tracking the adoption of DEX Diagnostic Exchange Z-codes in commercial insurance, monitoring the SALSA legislation’s impact on PAMA in Congress, assessing the FDA’s proposal to regulate LDTs as IVDs, and staying abreast of state laws concerning biomarkers.
In the realm of innovation, Quadax remains committed to identifying applications for AI and developing AI solutions to minimize claim errors, improve processing speed and accuracy, and automate billing modifications.

Anything else you’d like to share with us and our diagnostic reimbursement community today?

We very much enjoy networking with the diagnostic reimbursement community to find solutions for common reimbursement issues. Let’s connect at upcoming conferences and continue working together as a community to enhance patient care through improved coverage and reimbursement.

Thank you to the team at Quadax for replying to our questions!

If you’d like to meet with Quadax representatives, Tom Cronin, Senior VP of Revenue Cycle Strategy & Analytics at QUADAX will be presenting at the Q1 Productions 25th Diagnostic Coverage & Reimbursement Conference on December 6-7 in Boston, MA:

OPTIMIZING REIMBURSEMENT OPERATIONS FOR TESTS UNDER INCREASINGLY COMPLEX MEDICAL POLICIES
• Securing a clear understanding of payer medical policies & ensuring compliance
• Common obstacles encountered by labs amidst the growing complexity of specialized testing
• Specific challenges with different disease states & multiple clinical coverage criteria application to a single test
• Effective strategies & actions to implement to optimize reimbursement processes
• Analysis of essential data & insights pertaining to favorable coverage policies to improve revenue cycle management