Specialties / Labs & Diagnostics / Medical Billing & RCM

Labs & Diagnostics · Medical Billing & RCM

Full-Cycle RCM for Labs & Diagnostic Centers

Revenue cycle management built around PAMA reporting, LCD compliance, and ABN discipline — not standard physician billing.

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PAMA-Compliant
Billing & Reporting
LCD-Matched
Coding Before Submission
Audit-Ready
Molecular & Toxicology Billing

Lab billing runs on PAMA fee schedules, Local Coverage Determinations, and ABN rules that don't have close equivalents in physician office billing. We run full-cycle RCM for labs and diagnostic centers with that regulatory framework built into every stage — eligibility, LCD-matched coding, submission, denial management, and reporting.

What Matters Here

Why labs & diagnostics needs this differently

LCD compliance has to happen before submission, not after denial

Systematic diagnosis-to-test matching against Local Coverage Determinations needs to be part of the workflow, not a post-denial discovery.

PAMA reporting obligations are easy to underweight

Getting private payer rate and volume reporting wrong has downstream consequences for reimbursement that show up months later, disconnected from the original filing.

ABN workflows need to trigger correctly, not become a blanket habit

ABNs only protect revenue when issued before testing, tied to genuine non-coverage expectations — not as a routine hedge.

What's Included

Medical Billing & RCM, built for labs & diagnostics.

A dedicated implementation team and full transparency through your client portal — the same standard as everything else we run, tailored to how labs & diagnostics practices actually operate.

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PAMA-compliant billing and reporting for routine and specialty lab panels
Systematic LCD compliance checking against diagnosis codes before submission
ABN issuance workflows tied to actual coverage determinations
Molecular, genetic, and toxicology billing with audit-ready documentation
Reflex and add-on test billing rule management
Denial analysis by test type and payer

More for Labs & Diagnostics

Call Center Support for Labs & Diagnostic Centers

Results-related calls, ABN questions, and referring-provider coordination handled with lab-specific care.

Credentialing for Labs & Diagnostic Centers

CLIA-aware enrollment and payer credentialing for independent labs and diagnostic networks.

Back-Office Support for Labs & Diagnostic Centers

Claims processing and denial management built around lab-specific compliance and audit exposure.

Medical Billing & RCM for Other Specialties

Behavioral Health

End-to-end revenue cycle management built around MBHO carve-outs, session limits, and parity-related denial patterns.

Primary Care

Revenue cycle management built around E/M coding accuracy and CCM/AWV capture at high claim volume.

Cardiology

Revenue cycle management built around prior authorization volume, modifier 26 compliance, and device billing.

Multi-Specialty Groups

One revenue cycle operation with the coding depth to handle every specialty under your roof correctly.

Ready to get started?

A free revenue cycle assessment — you'll get a written breakdown of where the gaps are, whether or not you move forward with us.

Get a Free Assessment