Coding and Billing

Pathology Billing Service

The AdvantEdge pathology billing service starts with a process custom-designed for your practice or lab. It focuses on the most efficient and rapid means to acquire all needed information, with quality and integrity checks built-in. Also a complete review and update of credentialing (provider enrollment) information is conducted. Compliance issues and risks are highlighted and resolved throughout the entire process.

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Once implemented, the AdvantEdge pathology billing service sends accurate bills to each of your payers.  Your practice or lab sees daily financial and operational summaries. As claims are adjudicated, payments are posted and denials are automatically routed to the proper AdvantEdge expert for quick resolution. Secondary claims and patient balances are automatically billed. Outstanding balances with payers and patients are analyzed daily with each exception assigned to an accounts receivable expert.

An AdvantEdge client manager is available to your practice or lab at any time to review questions and as a practice management resource.

If your current pathology billing company isn’t exceeding your expectations, ask us to demonstrate why AdvantEdge is different from the competition. At AdvantEdge, we take pride in meeting each client’s specific needs, with consistently strong net collections and A/R performance. This “outsourced” billing reduces your fixed costs, while you retain control and visibility, including online “anytime, anywhere” access to your current financial performance.

Can your Pathology Billing Benefit from our Proven Results?


  • Collections up by 5 to 50%
  • A/R days outstanding down by 5 or more
  • Denials reduced up to 90%
  • Achieve net collections of 95+%


  • Advanced, robust technology and tools mean service to billing intervals in hours or days, not weeks
  • Process 99% of claims electronically
  • Comprehensive, real-time reporting
  • Visibility and control for your practice


  • You focus on clinical matters, not the “back office”
  • Lower staff and overhead costs


  • Trained, certificated, and ready to meet your unique needs.
  • Responsive service
  • Expertise
  • Confidence


  • Streamlined and fully compliant workflow means
    • Rapid, efficient claims processing
    • Fewer denials, faster denial processing
    • Automation of routine tasks
    • Reduced compliance risk


  • Solutions tailored to the specific needs of your group or lab
  • An extension of your practice
  • Advisor
  • Payer contract negotiations
  • Credentialing
  • Industry expert in regulations, coding, compliance

How the AdvantEdge Pathology Billing Can Serve You

  • Demographics captured via hospital downloads (HL7 and other)
  • Pathology Charge Capture including ADT and LIS interfaces
  • Daily reconciliation of charge batches
  • Electronic filing of pathology claims
  • Electronic Payer Remittance (ERA) from all payers that support them
  • Payment Posting with Daily Reconciliation
  • EFT payments wherever provided by payers
  • Lockbox, other Banking Arrangements
  • Patient Statements
  • Patient portal
  • Rapid Follow-Up with Payers, Patients
  • Denial Management
  • Expected vs. Actual Reimbursement Analysis
  • Charge reconciliation through accession analysis
  • Compliance Plan and Program
  • Powerful Pathology Billing System
  • Line Item Posting
  • All transactions fully journaled
  • Web-based dashboard with daily financial results
  • Customized Reporting
  • Client Management Expert Assigned to each Client
  • Options for chart auditing, credentialing, payer contracting, HR, Accounts Payable and more