A lab runs thousands of claims against payer coverage policies that change without notice. One misconfigured rule does not cost you a claim, it costs you a month of claims before anybody notices.
Generic billing services treat every claim the same. These are the patterns we look for first in laboratory practices.
A lab is paid on the ordering provider's documentation, which the lab does not control. Building the process that captures it up front is the difference between getting paid and appealing.
Diagnostic test coverage is tightly defined and varies by jurisdiction. Claims have to be scrubbed against the applicable LCD before submission, not after denial.
Billing components separately when a panel code exists triggers denials and audit exposure. The reverse, bundling when components were distinct, quietly underpays you.
At lab volumes, an error is never isolated. We categorize denials by root cause specifically so one fix corrects the whole batch.
Benefits and authorizations checked before the visit, not after the denial.
CPT, ICD-10 and modifiers validated against your documentation, with 100% audits for new clients.
Categorized by root cause, appealed with evidence, and fixed upstream so they stop recurring.
Oldest and largest first, with payments validated against your contracted fee schedule.
Payer enrollment and re-credentialing as part of the standard package, not an add-on.
Accuracy, turnaround and collections sent to you, not buried in a portal.
Send an extract of your denials. We will show you the root-cause breakdown, and how much of your volume a single rule change is affecting.
Request a free A/R review