Diagnostic Detail. Dependable Revenue.

Pathology Billing & Revenue Cycle Management

Our pathology RCM solutions match your precision. We help you code, bill, and report with total accuracy.

Robust RCM Solutions for
Pathology Practices

Pathology practices require specialized coding for a wide array of complex diagnostic services. With a deep understanding of pathology-specific billing needs, Health Prime ensures your claims are processed accurately and on time, reducing denials and increasing reimbursement rates. We help simplify the revenue cycle, making it easier for your team to focus on providing exceptional care.

Our specialized experience in pathology revenue cycle management extends beyond standard medical billing. We can help your practice collect every dollar by utilizing:

  • Accession Number Tracking
  • MIPS Consulting and Reporting
  • Payer Contract Management

The Tools You Need, Tailored for You

Technology that powers RCM performance

Health Prime’s proprietary EMR-agnostic technology platform is purpose-built to streamline pathology complexities, including multiple specimen types, intricate anatomical coding, and high-volume billing. We deliver intelligent automation, rule-based tools, and seamless integration that:   

  • Automates charge capture across lab, hospital, and EMR systems 
  • Utilizes advanced coding logic for layered CPT coding, ICD-10, anatomical site codes, and pathology-specific modifiers 
  • Ensures compliance and timely submission through automated claim scrubbing 

Data-driven analytics and business intelligence

Health Prime delivers timely business intelligence through customizable, detailed reporting dashboards for pathology practices that reveal actionable analytics across specimen volumes, CPT coding trends, payer behavior, and turnaround times.  

Pathology billing is complex—your data shouldn’t be. Our analytic capabilities empower you to: 

  • Monitor timely key financial and operational metrics  
  • Identify revenue risks and underpayment patterns early 
  • Optimize workflows and strengthen payer performance 

stay compliant with
our mips solutions

Navigate CMS regulations with confidence and simplify MIPS reporting using expertise tailored to the diagnostic and non-patient-facing nature of pathology. Our knowledgeable team can help your pathology group optimize MIPS performance and safeguard Medicare reimbursement. 

  • Access to over 20 QCDR quality measures, in addition to all national quality measures  
  • Annual optimization of your MIPS score with reporting recommendations  
  • Audit assistance 
  • End-of-year timely submission of MIPS data to CMS
  • Interpretation of MIPS regulatory changes as they relate to your practice
  • Regular performance monitoring

Results You Can Expect

Faster Claims & Fewer Coding Errors

Specialty-trained coders reduce delays and ensure accurate submissions from day one.

Boosted Revenue & Forecast Accuracy

More consistent collections and improved financial visibility for better decision-making.

Simplified Patient Billing

Straightforward billing communication that enhances the patient’s trust and payment experience.

What Sets Us Apart for Pathology Practices

Deep Coding Proficiency

Our coders are well-versed in pathology-specific codes, including complex molecular and diagnostic services.

Full-Spectrum RCM Support

From LIS integration to MIPS consulting, we manage the full revenue cycle with precision.

Quantifiable Results

Pathology clients report stronger cash flow and fewer denials after switching to Health Prime.

Clarity in Every Report

Tailored dashboards and insights designed to meet the reporting needs of pathology groups.

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It's all in the numbers

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Success rate of claims accepted on the first pass

Increase in reimbursement year-over-year

Increase in overall practice productivity

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It's all in the numbers

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Success rate of claims accepted on the first pass

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Increase in reimbursement year-over-year

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Increase in overall practice productivity

TESTIMONIALS

Hear From Our Clients

It was apparent that Health Prime’s attention to detail, willingness to delight its customer, and collaborative culture fit HPA’s vision and values. The transformation that has occurred through technology and customization has tremendously impacted our practice.

Hospital Pathology Associates

Health Prime’s services are very prompt. They’ve provided us with high quality problem solving.

Lake Shore Pathologists

Our new electronic workflows from Health Prime enable us to review pathology reports efficiently. We can discover and correct billing errors before they happen, reducing denials and decreasing days in AR.

Hospital Pathology Associates

We’ve had a great experience with Health Prime’s leadership team, especially their client management executives.

Winfield Laboratory Consultants

We love working with Health Prime. They are extremely knowledgeable and respond quickly to issues.

Southern Ohio Pathology

Want More?

Explore in-depth articles, updates, and expert insights on pathology revenue cycle management.

Unlocking Lost Revenue: Denial Management Performance for Pathology Providers

Discover how Health Prime helped a pathology group resolve more than 99% of their claims through targeted denial management and expert RCM support.

Pathology Billing & Revenue Cycle Management Solutions

Boost pathology revenue with Health Prime—tech-driven RCM solutions that cut denials, simplify billing, and help you recover more from every claim.

Smarter Billing Starts Here: The Benefits of Vendor Partnerships

Smart practices ditch DIY billing for expert partners—cut costs, boost revenue, and focus entirely on exceptional patient care.

Take The Next Step

Need a smarter, more specialized approach to pathology billing? 

Let’s talk about how we can strengthen your revenue cycle and simplify compliance.

Take The Next Step

Doctor Physician Team Meeting

Ready to simplify your revenue cycle and boost your practice’s financial performance? 

Contact us today to learn more or schedule a consultation.