Turn laboratory billing into a connected workflow
Most laboratory billing problems are intake problems that surfaced 45 days late. When billing reads the same validated order the laboratory ran, the claim is assembled from data that was already checked — and the problems appear while they can still be fixed.
Claims submitted
Clean claim rate
Denial rate
Days in AR
AR aging
Eligibility
1,394 checked · 181 exceptions routed to the eligibility queue
Denials by reason
| Reason | Payer | Claims | Value | Trend |
|---|---|---|---|---|
| Coverage not in effect | Payer A | 34 | $18,240 | Rising |
| Missing information | Payer C | 27 | $11,905 | Flat |
| Medical necessity | Payer B | 19 | $22,470 | Flat |
| Patient not found | Payer A | 12 | $4,860 | Falling |
| Duplicate claim | Payer D | 8 | $2,140 | Falling |
Illustrative interface. Figures are examples, not customer data.
Order → eligibility → coding → claim → payer → ERA → payment → reconciliation
Each step reads the record the previous one wrote. Nothing is re-keyed, so a denial can be traced back to the intake step that caused it.
- 01OrderTests, provider, diagnosis
- 02EligibilityCoverage confirmed on the order
- 03CodingCPT and ICD from the catalog
- 04ClaimAssembled and scrubbed
- 05PayerSubmitted and tracked
- 06ERARemittance ingested
- 07PaymentPosted against the claim
- 08ReconciliationAgainst expected reimbursement
Work queues are prioritized by what is actually blocking payment — missing information, failed validation, denial patterns — rather than by date order. Fifty claims held on the same missing field is one upstream problem, not fifty.
What the billing platform covers
Everything before the claim, the claim itself, the money, and the visibility over all of it.
Before the claim
Everything that decides whether the claim will be payable, done while the order is still in front of you.
Patient demographics
Captured and validated at intake, reused rather than re-keyed at billing.
Insurance information
Payer, plan, member and subscriber details captured from the requisition and insurance documents.
Eligibility verification
Coverage checked inside the order workflow, with the response stored on the order.
Insurance discovery
Coverage investigated where the patient supplied none or supplied the wrong payer.
CPT and ICD workflow
Codes derived from the test catalog and the order rather than reconstructed from the report.
Medical necessity checks
Diagnosis support surfaced during the order workflow, not discovered after a denial.
The claim
Preparation, submission and everything that happens between submission and adjudication.
Claim preparation
Claims assembled from the validated order record with payer-specific requirements applied.
Claim submission
Submitted through your clearinghouse relationship with submission recorded on the claim.
Claim tracking
Status followed from submission through adjudication, with stalled claims surfaced.
Claim status
Current state visible on the claim itself rather than assembled from clearinghouse reports.
Denial management
Denials grouped by reason, payer and originating cause so repeating patterns are visible early.
The money
Remittance, posting, patient responsibility and what remains outstanding.
ERA processing
Electronic remittance ingested, matched to claims and posted.
EOB processing
Paper and non-standard remittance handled into the same posting workflow.
Patient responsibility
Estimated early, tracked through adjudication and carried into statements.
Payment tracking
Payments posted and reconciled against expected reimbursement, not just against the billed amount.
Accounts receivable
Open AR by payer, client, age and balance, worked from queues rather than reports.
Aging
Aging buckets that reflect what is actually collectable and what is stuck.
Cash-pay workflows
Self-pay and client-bill arrangements handled alongside insurance without a separate process.
Visibility
Knowing where revenue is, before the month closes.
Payer analytics
Performance by payer: denial rate, days to payment, reimbursement against expectation.
Billing productivity
Throughput by queue and by team member, with the backlog visible.
Revenue dashboards
Billed, collected, outstanding and denied, against the volume the laboratory actually ran.
Billing work queues
Work prioritized by what is blocking payment rather than by date order.
Billing questions
Does billing require using your LIS?
It works best that way, because the claim is then built from the same validated record the laboratory ran. Billing against an external system is possible where a suitable interface exists for order and result data.
Can your team work our billing for us?
Yes — that is the managed billing service: eligibility, claim preparation and submission, denial follow-up, AR follow-up, ERA processing and payment posting, worked inside your platform and your audit trail.
How do you handle denials that keep repeating?
Denials are grouped by reason and payer, and the workflow is designed to trace a denial back to the intake step that caused it. The point is to fix the cause upstream rather than to appeal the same denial indefinitely.
Do you publish collection rate improvements?
No. Results depend on payer mix, documentation quality, test menu and the state of the existing AR. We will model expectations against your actual data during scoping rather than quote a number that means nothing.
Managed billing services
Our team working eligibility, claims, denials and AR.
AI Eligibility Intelligence
Coverage interpretation and exception routing, staff-reviewed.
LIS
The order record billing reads from.
Analytics
Revenue, AR, denial and payer dashboards.
How laboratory billing works
Stage by stage, and where the money is lost.
Integrations
Clearinghouse transactions for eligibility, claims and ERA.
Ready to modernize your laboratory?
Whether you need a complete LIS, billing infrastructure, workflow automation, integrations, or managed operational support, let's build the right solution for your laboratory.