Laboratory Billing & RCM Services
End-to-End RCM Support for Clinical, Genetic, Toxicology & Diagnostic Laboratories
Laboratory billing is one of the most complex segments of healthcare finance. Strict payer rules, evolving test codes, documentation gaps, and frequent medical necessity denials make lab RCM highly specialized.
Impact Innovations delivers a LabCorp-grade laboratory billing workflow, ensuring precise coding, compliance, medical necessity support, and optimized reimbursement across all lab types.
Whether you run a molecular lab, toxicology facility, pathology group, or multi-specialty diagnostic laboratory, our team manages the complete revenue cycle with unmatched accuracy.
Why Laboratory Billing Is Uniquely Challenging
Labs face consistent obstacles such as:
High denial rates for medical necessity
Frequent updates to ICD-10/CPT for molecular/genetic testing
Prior authorization complexities
Documentation requirements from ordering providers
High claim volume with strict turnarounds
Payer scrutiny around genetic and toxicology testing
Bundling rules for panels vs individual tests
Our workflow is built to address and prevent these issues proactively.
Our Laboratory RCM Services
1. Test-Specific Medical Coding
We specialize in:
Molecular diagnostics
Genetic testing
Toxicology
Pathology
Covid/respiratory panels
Immunology
Microbiology
Chemistry & hematology
Our coders ensure compliance with LCD/NCD guidelines and payer-specific medical necessity criteria.
2. Documentation & Medical Necessity Validation
Many lab denials originate from ordering provider documentation gaps.
We:
Request required documentation
Validate medical necessity
Apply correct diagnosis-to-test mapping
Flag tests requiring additional justification
3. Prior Authorization Support
We manage authorizations for:
Genetic tests
Advanced molecular panels
High-cost specialty assays
This reduces write-offs and improves revenue capture.
4. High-Volume Claims Processing
Labs often submit thousands of claims per day.
We use automation + manual review to ensure:
Clean claims
No duplicates
Accurate test codes
Proper bundling
5. Denial Management for Labs
Common lab denials include:
Missing documentation
Medical necessity errors
Bundling issues
Incorrect modifiers
Unlisted CPT codes
We aggressively pursue appeals and fix root causes to prevent recurrence.
6. AR Management & Payment Posting
Aged AR significantly impacts lab operations.
We keep AR under control with:
Persistent payer follow-up
Underpayment identification
Full ERA/EOB posting
Reconciliation with contracted rates
Benefits of Laboratory Billing with Impact Innovations
Reduced denials for molecular & genetic testing
Higher reimbursement accuracy
Strict compliance with payer policies
Faster claim submission
Complete end-to-end visibility
Scalable support for high-volume labs
Your Laboratory Revenue Cycle, Optimized
We support labs with the same precision, compliance, and workflows used by major diagnostic organizations.