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.
stats
It's all in the numbers
Success rate of claims accepted on the first pass
Increase in reimbursement year-over-year
Increase in overall practice productivity
stats
It's all in the numbers
Success rate of claims accepted on the first pass
Increase in reimbursement year-over-year
Increase in overall practice productivity
TESTIMONIALS
Hear From Our Clients
Want More?
Explore in-depth articles, updates, and expert insights on pathology revenue cycle management.
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
Ready to simplify your revenue cycle and boost your practice’s financial performance?
Contact us today to learn more or schedule a consultation.