Billing Company

Pathology Billing Company

A pathology billing company usually implement the following steps:

  • Charge capture/entry
  • Claims filing
  • Payment posting
  • Reporting
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Most pathology billing companies also perform some Accounts Receivable work. At AdvantEdge, we take it much further and the results speak for themselves. At AdvantEdge:

  1. Comprehensive LIS, ADT and other hospital interfaces not only collect charge information quickly, they incorporate error correction and reconciliation processes to assure that every accession performed is billed.
  2. All billing work is visible to clients on a daily basis.
  3. Coding is performed by AdvantEdge certified coders, assuring accurate and fully compliant billing. In addition to immediate clarification on unclear documentation, our coders provide regular feedback to improve physician documentation and, where desired, physician education classes.
  4. 99% of all clearinghouse claims filed are accepted. Sophisticated claim edits assure that only clean claims are filed.
  5. All EOB information, including denial information, is posted.
  6. Secondary claims are filed automatically as soon as the primary payment is posted.
  7. A patient statement is immediately issued if a patient balance exists after an insurance payment.
  8. Multiple patient payment options are available; online portal, phone or mail with the full variety of payment types available: credit card, check, e-check, etc.
  9. Denials are processed immediately by the appropriate specialist, based on the type of denial.
  10. Underpayments are identified and worked by an insurance specialist.
  11. Delays in payment from insurers or patients are processed by A/R follow-up experts.
  12. Comprehensive reporting and analysis is provided monthly and, where requested, on a daily and weekly basis.
  13. The AdvantEdge Client Manager works as an extension of your practice, lab or hospital and is available at any time to answer questions and to provide additional information on the full range of pathology billing, coding and business intelligence.
  14. We provide a full range of practice management services, beginning with enrollment (credentialing) and insurance contract negotiations. Plus, as required, some or all HR, accounting and financial support.

AdvantEdge Analytics: Pathology Billing Information Anytime, Anywhere

In the past, a set of monthly reports was all that was expected of a pathology billing company. Today the expectations are very different. Pathology practices and labs expect easy access to current billing results every day, whenever they wish.

AdvantEdge Analtics (A2) online portal provides HIPAA-compliant access to summaries and details of charges, adjustments, collections, A/R, procedure volumes.

The data is updated daily with “drill-down” access to detailed information by payor, provider, location, etc. In addition, regularly scheduled reports are delivered to A2e with no delays from paper distribution and no need to email patient-protected information. Ad hoc reports can also be requested via A2 and delivered to the dashboard. The entire dashboard and reporting system conforms to federal standard NIST SP 800-52 and other relevant standards required by HIPAA and HITECH encryption standards.

ClientFirst Service

Our ClientFirst approach means we believe in complete transparency when working with our clients. InfoEdge is one dimension of that transparency and visibility.

We communicate in as many ways as you prefer about practice performance, day-to-day management of the revenue cycle and strategic direction. Your AdvantEdge Client Manager represents our entire company and is available to you at any time. Our team of coding, billing and practice management experts constantly communicate on your account. And our executives are an integral part of your support team.

Every one of our staff members is focused on the performance of your practice and lab. Unique in the industry, our staff members have incentive bonuses tied to superior results for your group. At AdvantEdge, we know that your practice is more successful when communication flows easily from the “back office” (e.g. billing office) to your lab, physicians, and administration.

As a matter of philosophy, we want to operate as a business partner, not just a vendor. We find that this cooperative, “win-win” approach yields better results for you and for us. We look forward to the opportunity to demonstrate how this partnership can benefit your group.

Billing in House? Could a Pathology Billing Company be a Better Solution? 

Traditionally, some practices and labs felt they needed in-house billing to keep “control.”  With today’s sophisticated informatics and communications, AdvantEdge allows you to keep that control. In fact, many practices now feel that they have more control with a billing partner than with their own staff.

In addition to cost advantages (a variable billing cost instead of the fixed and growing expenses of an in-house operation), a billing company has a much deeper bench of expertise available to your group. And companies like AdvantEdge offer technology capabilities that no in-house operation can afford or develop.

To find out more, have us prepare an Financial Review to compare costs and capabilities. Call us at 877 501-1611 now to get started!