Our services

Our laboratory billing services are adept and reputable, and can process the pathology and laboratory claims with agility and quality.

Accurate and timely coding

Accurate and timely coding of pathology and laboratory procedures and services, using the latest CPT® and HCPCS Level II codes and modifiers, as well as following the official coding guidelines and payer policies.

Effective and proactive denial management of pathology and laboratory claims, using the best practices to identify, analyze, and resolve the root causes of denials, as well as to prevent them from recurring in the future.

Effective and proactive denial management

Efficient and compliant billing

Efficient and compliant billing of pathology and laboratory claims, using the appropriate fee schedules, RVUs, and payment methods for different types of services and settings, such as professional component, technical component, global method, and Part A.

Clear and concise patient statements

Clear and concise patient statements of pathology and laboratory charges, using easy-to-understand language, summary of the charges, breakdown of charges by date and service, and point of contact for questions.

Data security and privacy of pathology and laboratory information and records, using the best practices to protect the confidentiality, integrity, and availability of the data, as well as to comply with the HIPAA and other relevant laws and regulations.

Data security and privacy

Routine interpretation of billing reports

Regular analysis of billing reports using the key performance indicators and benchmarks to assess the financial health of the practice, identify underperforming areas, and create action plans to address the issues impacting the revenue cycle.

Lab Billing FAQs

What information is required for lab billing?

To properly process a lab billing, you need the patient's personal details, insurance information, the physician's order, the lab tests or procedures performed, and the corresponding CPT codes for each service. This ensures accurate and timely billing.

How do insurance companies handle lab billing?

Insurance companies typically cover lab tests as part of a patient's healthcare plan, though coverage may vary. The lab submits claims to the insurance company, which reviews the tests based on the patient’s policy, determines coverage, and processes payment. Any remaining balance not covered by insurance is the patient's responsibility.

How does outsourcing lab billing improve accuracy?

Outsourcing companies specialize in medical billing and are up-to-date with the latest industry standards, CPT codes, insurance requirements, and compliance regulations. This expertise reduces the risk of billing errors, denials, and the need for costly rework, ensuring more accurate and timely claims.

Is outsourcing lab billing scalable for growing labs?

Yes, outsourcing offers scalability. As a lab grows or experiences fluctuations in test volumes, the outsourcing company can adjust its services to accommodate the changing needs, without the lab needing to hire or train additional in-house staff.

How can I contact you?

You can reach us by (202) 990-6419. We are always happy to answer your questions.