Pathology Billing Services

Unique billing requirements create challenges for pathology practices, groups and labs. In order to successfully submit and collect on claims, billers and coders need to have in-depth knowledge of the sub-specialties in pathology, and they must have a current working knowledge of billing guidelines and updates about CPT codes for pathology services. With increasing scrutiny and tightening restrictions on laboratory billing practice management, it is imperative that clinical pathology labs implement stringent compliance procedures in accordance with changing laws and regulations.

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.

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. 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.

The sure ways solutions 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. 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.

The sure ways solutions is an industry leader and trusted name in medical accounts receivable collections because we know how to get results. Our mastery of complex medical coding and AR management services sets us apart. But it’s our breadth of knowledge that allows us to shine. Our medical billing company successfully serves healthcare facilities of all types and sizes, and we specialize in medical billing for physicians, laboratories, radiology & imaging centers, and hospitals. We know it’s difficult to remain entirely focused on patient care when you’re worried about your bottom line. If you’re spending valuable time and energy trying to diagnose finances, then perhaps it’s time to enlist the aid of a professional medical billing company like The sure ways solutions.