Revenue Cycle Services
The field of Laboratory Medical Billing is under intense scrutiny. After OIG announced a close review of independent laboratory billing practices, CMS has increased its oversight on laboratories, making the billing process much more complex. With the fall in the reimbursement rates, costs getting higher, and billing norms becoming more stringent, the need for proficient and process compliant laboratory medical billing services is at its boom.
Familiarity with Independent Laboratory Medical Billing HCPCS, CLIA amendments, PAMA updates, is what is important for medical billers. The chances of error are supposed to be minimal. At Genesis, we understand the number of billing challenges that laboratories face. The complexity of laboratory billing standards, ever-changing payer requirements, and difficulties accessing information can hamper growth and your business’s success. Our years of Independent Laboratory billing experience has made it possible to overcome these volatile billing challenges with ease, hence enabling our clients to focus on their core competencies and consequently grow their bottom lines.
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Laboratory Billing Experience
MOLECULAR BILLING AND CODING
Molecular laboratories are in great demand nowadays. But along with it, there will be great responsibilities and challenges in billing and coding. The molecular testing industry have been dynamically rising and CMS reviews the top genes tested each year to rewrite codes which makes it harder to keep up with.
Non-compliance makes billing tough. In order to ensure proper reimbursements for molecular lab tests, it is imperative that laboratories stay on top of the billing and coding updates and practices.
Genesis has the required expertise in offering expert molecular billing and coding services. We ensure maximum reimbursement, complete adherence to old as well as new laboratory billing guidelines, and also take care of the follow-up procedures, so you do not have to.
TOXICOLOGY LABORATORY BILLING SERVICES
Toxicology Laboratory Billing is the most unpredictable and frequently changing field of lab billing. The disruption of G-codes by Medicare in 2016 to classify testing techniques was a huge drift. Three categories of G-codes, each for presumptive testing and definitive testing were created to cope over utilization and other false practices.
Over-utilization is yet another focal point of careful examination by the CMS, OIG and the U.S DOJ. Therefore, reception of appropriate reimbursement requires lab medical billers to be always updated.
The knowledge of rules relating to modifier application and diagnosis codes is important. The team a Genesis has helped to ensure toxicology labs of growth in revenue with their highly competent toxicology lab billing services.
PATHOLOGY LABORATORY BILLING
Billing for pathology laboratory services can be particularly challenging. It is necessary for the billers to have the understanding of pathology’s many sub-specialties such as cytopathology, toxicology, and hematology, etc.
Making matter worse, there is a huge set of rules and regulations that control Pathology laboratory billing. Therefore, it is imperative that pathology lab billers are acquainted with the same for lucrative results. A thorough understanding of the pathology lab terms and procedures ensures smooth billing transition and removes billing challenges that result in lesser denials and boosted payments.
At Genesis, we make consistent efforts to keep up with the changes in CPT codes, CCI edits and pathology laboratory billing guidelines, leaving close to no space for error.
CLINICAL LABORATORY BILLING SERVICES
The services provided by a clinical laboratory include pathological, biological, chemical, microbiological, biophysical, hematological & immune-hematological, serological, cytological and other procedures. Now, in order to qualify these services have to meet the requirements as mentioned in 42CFR Part-493 of CLIA, 1988. Moreover, CPT4-80000 series and ICD-10 diagnosis codes are required to bill clinical lab tests. There are exceptions to the use of diagnosis codes that need to be considered.
The room for an error is small, and no practice can afford to lose money and invest precious time fighting and appealing against denials. Our team of billers and coders understands the requirements to ensure medical necessity and maintains familiarity with the latest technology and the ever-changing CPT and ICD-10 codes.