Laboratory Billing Services to Strengthen Your Revenue Cycle
While you focus on delivering accurate test results, we maximize your revenue with our laboratory billing services. Our main lab billing expertise includes:
- Compliance with CLIA, HIPAA, and payer-specific regulations
- Pre-authorizations for high-cost genetic and diagnostic procedures
- Accurate charge capture for molecular, pathology, and clinical tests
- Seamless LIS and EHR integration for clean claim submission
- Detailed reporting and analytics to track lab financial health
What are Some Lab Billing Challenges Faced by Laboratory Around the United States?
Here are the top billing challenges laboratories face:
Complex Test Coding: Labs require expert billers to manage frequent CPT and HCPCS updates for molecular and clinical testing.
Prior Authorizations: High-cost molecular and genetic tests often need timely pre-approvals to avoid claim denials and revenue loss.
Specialized LIS Integration: Laboratory billing experts streamline data from lab systems to claims, reducing errors and accelerating payments.
Compliance with CLIA: Specialized lab billing teams keep labs compliant with the latest regulations and payer-specific rules.
How Transcure Handles Laboratory Billing Challenges?
Challenge
Complex Test Coding
Prior Authorizations
Specialized LIS Integration
Compliance with CLIA
How Does Transcure Handle this Lab Billing Challenge
Transcure has a specialized lab coding team that stays updated with CPT and ICD-10 codes. Our experts implement automated scrubbing to prevent miscoding and denials.
Our lab billing services providers coordinate prior authorization workflows with eligibility checks and follow set protocols to prevent costly denials.
With us, you get fully integrated services that connect with your Laboratory Information System and EHRs, ensuring clean data flow.
Transcure monitors regulatory updates and payer-specific rules, ensuring your laboratory billing processes remain compliant with CLIA standards.
Comprehensive Laboratory Billing Services for Labs of Every Size and Type
Independent Labs Billing
Independent laboratories often struggle with payer-specific rules and revenue leakage. Our laboratory billing experts handle everything from claim submission to denial appeals. This makes sure that labs receive maximum payments without increased overhead.
Hospital Laboratory Billing
Hospital-based labs have complex billing workflows that require precise coordination with hospital RCM teams. We specialize in integrating lab billing with hospital systems, accelerating reimbursements for high-volume testing.
Physician Office Labs Billing
Physician-owned labs face unique compliance and coding challenges. We streamline lab billing for in-office tests, manage prior authorizations, and keep practices compliant while supporting sustainable growth.
Toxicology Laboratories Billing
High-value toxicology services often undergo strict payer audits. Our outsourced laboratory billing team manages coding for confirmatory testing, ensures compliance with medical necessity requirements, and prevents costly denials.
Molecular Diagnostics Labs Billing
Genetic and molecular testing generate high revenue but require accurate coding and bundling knowledge. For accuracy, our lab billing services handle the complexity of NGS panels, PCR, and advanced genomic testing with precision.
Pathology Laboratories Billing
Pathology lab billing demands expertise in biopsies, immunohistochemistry, and cytogenetics. Transcure has certified billers to ensure accurate documentation, coding, and compliance, helping labs avoid underpayments.
Does Transcure Offer Laboratory Billing Services with Nationwide Reach?
Transcure is setting new standards in laboratory billing across the United States. With coverage extending to every major state, we provide lab-focused billing solutions that align with regional payer rules and CLIA requirements.
Complete Expertise in Laboratory CPT Coding and Billing
59400
- Comprehensive metabolic panel
85025
- Complete blood count with automated differential
81001
- Urinalysis with microscopy
87086
- Urine culture, bacterial
88305
- Level IV surgical pathology, microscopic exam
87635
- SARS-CoV-2 detection by probe technique
81225
- CYP2C19 gene analysis (pharmacogenomics)
81445
- Targeted genomic sequence panel
88112
- Cytopathology, selective cell enhancement
Compare How Much You Can Save After Outsourcing Laboratory Billing Services to Transcure
In-House Billing
The calculations are done for small to medium-sized laboratory.
Annual Salary: $25000 to $35000
Overhead Cost: $15000 to $25000
Downsides
Not Cost-Efficient
Less Skilled Billers
Lacks Automation
Outsourcing to Transcure
The calculations are done for the lab earning around $100000 per year.
Transcure’s Rate: 5% on average
Total Amount: Approximately $5000
Upsides
Save up to $45000 annually
Team of over 1100 skilled billers
RPA-powered Billing
Stop Lab Billing Claim Denials with CLIA and LIS Accuracy
In laboratory billing, the Clinical Laboratory Improvement Amendments number is a required 10-character identifier for any facility testing human specimens to meet quality standards. Missing or invalid CLIA numbers on billing forms like the CMS-1500 or UB-04 often result in costly denials and payment delays.
Transcure helps labs by validating CLIA numbers to ensure compliance with Medicare and Medicaid. Our lab billing services also integrate LIS data seamlessly into billing workflows to handle coding and claim submissions properly.
Our Success in Numbers
Why Choose Transcure for Laboratory Billing Services?
Advanced Analytics for Laboratories
Laboratories can make smarter operational and financial decisions with powerful analytics. As labs manage high-volume testing and evolving payer rules, our insights help identify revenue leaks and optimize payment strategies.
Automation Tools and RPA
Human error remains one of the leading causes of claim denials in laboratory billing. Our robotic process automation (RPA) improves data entry, eligibility checks, and claim submission, which facilitates accuracy and speeds up payments.
Transparent Pricing Structure
Our outsourced laboratory billing experts offer a percentage-based billing model with no hidden costs. This gives your laboratory predictable financial outcomes and complete visibility into revenue cycle management expenses.
Distinctive Laboratory Billing Technology
Unlike many providers, Transcure combines expert billers with advanced RCM technology. From seamless LIS integration to compliance safeguards, our platform helps you get cleaner claims and stronger cash flow.
Transcure’s Onboarding Process for Laboratory Medical Billing
Welcome Call
Your journey with Transcure begins with a personalized welcome session. We walk you through our laboratory billing process and outline how we’ll support your lab’s financial success.
Laboratory Setup Questionnaire
You’ll receive a structured questionnaire to provide essential details such as CLIA number, laboratory type, LIS requirements, test volumes, and payer mix.
Onboarding Meeting
Our lab billing experts guide you through a detailed onboarding consultation. During this stage, we coordinate secure access to your LIS, EHR, and billing platforms.
Defining Workflow SOPs
Based on your lab’s unique operations, we create customized standard operating procedures. These define the entire billing cycle, from test order capture and coding to claim submission.
Go-Live Date
After thorough preparation, your laboratory billing services officially go live. On the launch date, all lab billing operations transition seamlessly to Transcure’s team.
One Fits All LIS Integration for Lab Billing
Our experts specialize in connecting laboratory billing services with leading Laboratory Information Systems (LIS). From test ordering to results reporting, we facilitate LIS integration that supports accurate charge capture and claim submission.
Trusted Laboratory Billing Outsourcing Services
See why laboratories across the United States rely on Transcure as their preferred partner for outsourced lab billing. Read these testimonials to get a better idea.
Dr. Anthony
National Medical Labs
“Transcure t has helped us save countless hours and improve our bottom line. The team is friendly, professional, and always available to answer our questions.”
Dr. Richard
Laboratory Manager.
“I used to dread our billing process, but since implementing Transcure, it has become much more manageable and efficient.”
Dr. Susan
Laboratory Manager.
“Transcure helped us save time and improve accuracy in our billing coordination. Highly recommended for any lab!”
Frequently Asked Questions (FAQs)
Can a physician bill for laboratory services?
Yes, physicians can bill for laboratory services if the tests are performed within their practice or office lab. However, proper CLIA certification and correct CPT coding must be followed to prevent denials in laboratory billing.
Do labs need an EHR, or is an LIS enough for billing?
An EHR is not always required for laboratory billing. An LIS often integrates directly with billing software, handling test orders, results, and coding. Many labs rely solely on LIS for efficient revenue cycle management and compliance with payer rules.
How much does it cost to outsource laboratory billing services?
The cost of outsourcing laboratory billing typically ranges from 6% to 10% of collections. However, Transcure offers an affordable pricing range of 4 to 5% of the monthly revenue, which makes it a go-to choice for lab billing outsourcing.
What's the difference between LIS and LIMS in lab billing?
A Laboratory Information System is designed for clinical labs to support diagnostic testing, coding, and billing. On the other hand, the Laboratory Information Management System (LIMS) serves research or industrial labs, focusing on sample tracking and data management.
