The sustainability of any business depends on getting paid for its products or services, and medical labs are no exception. Medical billing is complicated, so it is extremely important to have an efficient process in place to ensure that claims are submitted in a timely manner and none get lost in the shuffle due…

With the way things are going in laboratory billing, it’s crucial that you don’t stay stagnant. The field is always expanding, and with new tools for business improvement emerging constantly, you don’t have to rely on outdated methods of laboratory billing. By utilizing some of the latest innovative solutions to face today’s billing challenges, your…

3 Tools to Improve Your Laboratory Billing Practices

If your lab handles billing in-house, you always have to be on the lookout for tools to improve your billing practices. After all, the goal is to stay competitive and profitable. Large labs generally rely on robust software systems to ease their workflow, but for smaller companies, this can be seen as a difficult or…

CPT Billing Code

CPT Codes are codes that you and other medical professionals and laboratory personnel use to document the medical services and procedures you provide to patients. CPT stands for Current Procedural Terminology, and the five-digit codes are recorded by medical billing specialists who process laboratory billing claims. Each unique code corresponds to a designated service, translated…

Laboratory Billing and Coding

What exactly is the process for laboratory billing, and who is involved? In simple terms, the laboratory billing cycle is a series of interactions between a clinical lab (or its outsourced medical billing service company like Medcare MSO) and the patient’s insurance company. The length of the laboratory billing cycle is determined by the complexity…

Laboratory billing is challenging, but there are five simple ways to avoid denials for increased collections. When it comes to denials in laboratory billing, there are two distinct types—“hard” and “soft” claims. Hard claims cannot be reversed because the revenue has been completely written off due to the age of the account or other factors….

Molecular (Genetic) Laboratory Billing While genetic testing is a relatively new field of laboratory testing, it is growing at an exponential rate. Why? Because it provides patients with fact-based lab results which allow them to make informed decisions about medical care. Molecular testing also allows providers to suggest appropriate preventive care, monitoring protocol, and treatment…

The Merit-Based Incentive Payment System (MIPS) is one of two payment tracks under the MACRA program. The purpose of the program is to deliver high-quality care for all—including both clinicians and patients—improve beneficiary options, enhance the experience for clinicians, and maximize participation. MIPS consolidates and replaces several previous programs. In this new system, there are…

Before diving into this, let’s discuss what the Protecting Access to Medicare Act (PAMA) is exactly. PAMA is a bill that extends an already existing program, providing more direction than given in previous years. The act was signed into law on April 1st, 2014 and included extensive reforms to the Medical Clinical Laboratory Fee Schedule…

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