Why Outsource Your Pathology Billing and Coding?
Let Your Team Focus on the Science
Your lab’s core mission is accurate diagnostic work, not chasing down payments. We take the complexities of the revenue cycle off your plate.
Access Deep Coding and Regulatory Knowledge
Our team lives and breathes pathology billing. From histology and cytology to molecular diagnostics and clinical testing, we understand the relevant coding required.
Support Your Laboratory’s Expansion
As you add new tests or open new locations, our services scale with you. You avoid the high cost of new software and the challenge of finding and training specialized billing staff.
Create Predictable, Stronger Revenue
We specialize in submitting error-free claims from the start. This reduces delays and denials, which means a more consistent and reliable cash flow.
Decrease Your Operational Overhead
Partnering with us means you can eliminate expensive in-house billing software subscriptions and ongoing maintenance fees.
Unlock Actionable Financial Insights
Our reporting provides a clear view into your lab’s financial health. This lets you address revenue leaks before they become serious problems.
Custom-Built Billing Solutions for Modern Laboratories
Every lab is unique. A small independent private pathology laboratory faces different challenges than a high-volume lab inside a private hospital. We understand that a one-size-fits-all approach doesn’t work for everyone.
Our team collaborates with you to build a billing process that integrates properly with your existing laboratory information system. We provide specialized support for various pathology environments, including:
– Anatomic and surgical pathology groups
– Clinical and molecular diagnostic labs
– Dermatopathology and esoteric testing facilities
Smarter Lab Management
Our analytics dashboard turns raw billing data into information you can actually use to improve your lab. We make it simple to monitor vital key performance indicators specific to pathology, like reimbursement levels for new, complex pathology tests.
These insights give you the evidence you need to spot underperforming contracts and confidently negotiate improved fee schedules with any private health insurance fund.
Speak With Our Pathology Billing Strategists!
Let our team help you identify and capture the full revenue you’ve rightfully earned. You can then reinvest that capital where it matters most, from buying new equipment to expanding your diagnostic services.
Why Pathology Specialists Trust Our Services?
Effortless Provider Credentialing
We fast-track the entire credentialing and enrollment process and ensure your pathologists are properly set up with every commercial and government payer, including Medicare.
End-to-End Revenue Cycle Oversight
We manage every financial aspect, from handling inbound inpatient pathology services referrals to charge capture and patient invoicing.
Handling Compliance
We ensure your laboratory stays fully compliant with regulations like HIPAA and follows the guidelines set by bodies like the Australian Medical Association and the Medicare Benefits Schedule.
A Simplified Patient Process
We verify a private patient’s personal and test eligibility upfront. Our secure system can store credit card details to manage out of pocket expenses.
Unmatched Coding Accuracy and Auditing
Our certified coders conduct regular audits to guarantee your practice consistently uses the most accurate and optimal codes for all your pathology billing services.
Insightful Performance Benchmarking
We provide detailed reports comparing your lab’s key metrics against national and regional benchmarks. This helps you gauge your productivity and see if you are eligible for a Medicare bonus for meeting specific criteria.
Frequently Asked Questions
Billing for pathology services involves assigning the correct CPT code for each specimen, whether it’s surgical, clinical, molecular, or cytopathology. You’ll also need to apply the correct professional or technical component modifier and place of service, and include support diagnosis codes. Molecular and esoteric tests require LCD compliance documentation to meet payer coverage requirements and prevent medical necessity denials.
The best pathology billing companies in the USA have deep coding and regulatory knowledge specific to pathology, from histology and cytology to molecular diagnostics and clinical testing. They offer specialized support for various pathology environments and understand the unique challenges faced by small, independent pathology laboratories and higher-volume labs inside private hospitals. PMN’s certified specialists have expertise in everything from surgical pathology to molecular diagnostics, with denial rates below 0.02%.
Yes, all specialist pathology billing services can accurately split technical and professional component billing, ensuring the right modifiers are applied to each claim. This prevents the component errors that offer cause systematic underpayments for pathology groups. They also handle coordination rules that apply when technical and professional services are billed by separate entities for the same specimen.
Outsourcing pathology billing costs 4%-8% of your collections. While this may seem expensive, outsourcing provides an overall great return on investment by helping you avoid the high costs of in-house billing software and finding and training specialized billing staff as your laboratory expands. Furthermore, PMN offers even more competitive rates for qualifying pathology practices, starting at 3% with no additional setup fees.
