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Pathology & Laboratory medical billing services
Pathology and lab billing is high-volume and detail-heavy, with specimen counts, molecular tests and medical-necessity rules. We code each specimen and test correctly and handle the denials labs typically see.
Why pathology & laboratory billing is different
These are the issues that most often cause denials and lost revenue in pathology & laboratory. Our team handles each one.
- Surgical pathology coding by specimen and level
- Molecular and genetic testing with PLA codes
- Medical necessity (ICD-10 to test) requirements
- Missing demographics and insurance from ordering providers
Services and procedures we handle
Everything your pathology & laboratory practice needs
Medical Billing & Coding
Certified coders and billers who turn every encounter into a clean, compliant claim.
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Credentialing & Enrollment
Get providers enrolled with payers faster, and keep them active.
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Denial Management
Work every denial, win the appeal, and fix the root cause.
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A/R Recovery & Follow-Up
Turn aging receivables into cash, starting with the highest-value claims.
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Eligibility & Benefits Verification
Know coverage, copays and deductibles before the patient walks in.
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Prior Authorization
Authorizations requested, tracked and approved before care is delayed.
Explore serviceSwitching is simpler than you think
Free revenue audit
We review your A/R aging, denial history, payer mix and coding patterns, then show you what is recoverable.
Onboarding
BAA signed, secure system access set up, workflows mapped and your dedicated team assigned.
Daily operations
Claims, payments, denials, A/R and patient billing are worked every business day.
Monthly review
A KPI report and a call with your account manager covering results and next steps.
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Frequently asked questions
Straight answers about how ClaimEdgeSolutions works with your practice.
Ask us anything01How do you handle missing patient information?
We work with ordering offices to get complete demographics and insurance before claims are submitted.
02Do you bill molecular tests?
Yes, including PLA and Tier 1/Tier 2 molecular codes with required documentation.
03Do your coders have pathology & laboratory experience?
Yes. Your account is assigned coders and billers with pathology & laboratory experience who know its codes, modifiers and payer rules.
04How quickly can we switch to ClaimEdgeSolutions?
Most practices are fully live in 2–4 weeks. We work alongside your current team or vendor during the transition so cash flow is not interrupted.
Get a free pathology & laboratory billing audit
We review your denials, coding patterns and A/R and show you exactly where revenue is being lost.