Pathology Lab Billing Services
To achieve a streamlined pathology billing process, it’s essential to have a knowledgeable billing team with hands-on experience in claims recovery. The experts at MedEx MBS offer comprehensive, user-friendly billing services designed to enhance your financial performance and support your growth trajectory.
Advantages of Our Innovative Pathology Medical Billing Solution
You Need To Have In-Depth Knowledge
The unique billing requirements present challenges for pathology practices, groups, and labs. To successfully submit and collect claims, billers and coders must possess in-depth knowledge of the various pathology sub-specialties, as well as up-to-date familiarity with billing guidelines and current CPT codes for pathology services. With increasing scrutiny and stricter regulations on laboratory billing practices, it is essential for clinical pathology labs to establish rigorous compliance procedures in line with evolving laws and regulations.
Merit-Based Incentive Payment System
Perhaps an even greater challenge than federal and commercial guidelines, however, is the Merit-Based Incentive Payment System (MIPS), which determines Medicare payments according to scores in four performance categories: Quality, Cost, Improvement Activities (IA), and Promoting Interoperability (PI). To prevent payment cuts in 2020, and to earn the maximum incentive, pathology labs must report on six Quality measures and up to two IA measures.
It is critical to manage Documentation And Reporting
The future of your lab’s revenue cycle management hinges on accurate documentation and proper reporting. It’s essential to refine both front-office and back-office procedures to maximize reimbursement from all payers. Many insurance companies have tightened their provider networks, increasingly classifying pathology labs as out-of-network providers. Compounding this challenge, health insurers are imposing stricter limitations on benefits, making it increasingly difficult to collect payments from both insurers and patients. While you may not have control over coverage, you can reduce the risk of denied claims and collection issues by verifying eligibility prior to providing services.
