Pathology Billing Services

For Streamlined Pathology Billing Process, it is important to have a knowledgeable billing team that has hands-on experience in claims recovery. The professionals at Medcare MSO provide full-featured, simple and intuitive billing services that leverage your financial performance & growth trajectory.

Advantages of Our Innovative Pathology Medical Billing Services

You Need To Have In-Depth Knowledge

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. Accurately billing for each component of pathology procedures is crucial to ensure proper claims adjudication. Proper coding and documentation for surgical consultation services are also significant for accurate claims adjudication.

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 revenue cycle management of your lab depends on accurate documentation and proper reporting. It is critical to adjust front-office and back-office procedures to ensure maximum reimbursement from all payers. Credentialing plays a vital role in enhancing patient enrollment and insurance management. Effective denial management contributes to minimizing operating costs and maximizing revenue. Many insurance companies have narrowed their provider networks, and pathology labs are increasingly deemed out-of-network providers. Adding to the challenge is the fact that health insurers are placing greater limitations on benefits. It’s becoming more and more difficult to collect payments from insurers and patients alike. You may not be able to do anything about coverage, but you can avoid these types of denied claims and collection accounts by verifying eligibility before providing services.

Your Revenue, Our Priority—Partner with a Leading Pathology Billing Company!

Let's team up to streamline your medical billing processes and manage the entire revenue cycle, boosting your revenue growth by up to 30%.

Pathology Practices and Billing Challenges

Pathology practices face some of the most complex billing challenges out there. To succeed, they need to have a deep understanding of the intricacies of pathology billing—and the regulations that govern it. That’s where specialized expertise and knowledge of pathology medical billing services come in. Laboratory billing consultants can guide them through those complexities, offering expert advice on billing and revenue growth. By getting a handle on the billing process and laboratory billing services, pathology practices can streamline their revenue cycle management, reduce denials and increase cash flow. That support—tailored to their needs—ensures they stay on top of ever-changing regulations and get the reimbursement they deserve.

Case Studies and Success Stories

Many case studies and success stories prove the benefits of outsourcing in medical billing. For example a pathology practice that outsourced their billing to us reduced their denial rate by 30% and increased their cash flow by 25%. Another pathology practice that implemented our advanced billing software improved their charge capture by 20% and reduced their lost revenue by 15%. These success stories show the importance of specialized expertise in billing especially in pathology medical billing services. By partnering with a reputable medical billing company like MedCare MSO, pathology practices can manage their revenue cycle, reduce denials and improve patient care. These real life examples show the tangible benefits of outsourcing and technology integration, a roadmap for other pathology practices to follow.

Successful Medical Claims & Increasing Reimbursement

As if all of these challenges aren’t enough, timely sample processing and reporting are integral to filing successful medical claims and increasing reimbursement rates. Proper coding in the diagnosis process is essential for successful claims adjudication. Expertise in auditing and optimizing billing processes for hospitals is also crucial. Laboratories face significant challenges regarding coding accuracy and compliance. Precise coding and submission for laboratory tests are critical to avoid claim denials and financial losses. Altogether, the regulations and reporting requirements are confusing and time-consuming, resulting in delayed or lost payments. For many pathology labs, these challenges can make or break your business, but with assistance from a dedicated team of laboratory billing experts and analysts, you can take control back.

We Keep Your Lab Profitable

Medcare MSO provides comprehensive pathology billing services that identify and address potential compliance, regulatory, and reporting issues before they occur to keep your lab profitable and less operational costs. Pathologists often face challenges in managing their medical billing internally, which can hinder clinical efficiency. Physicians play a crucial role in managing compliance with regulations like the No Surprises Act while improving revenue cycle management. Efficient claim submission is vital in achieving optimal results in revenue collection. We do aggressive claims follow-up and effectively collect on old A/R accounts to recover lost revenue, and we submit accurate, timely claims for consistent revenue streams and cash flow. Our certified medical billing professionals have specialized expertise in pathology medical billing services which results in a shortened reimbursement cycle and maximized profitability.

Increase your Practice Revenue by up to 30% With Medcare MSO

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