4.9/5.0
100+ Providers Trust
Accurate Billing Solutions for Medical Laboratories
We deliver precise laboratory billing services, ensuring compliance and optimal reimbursement outcomes.
CPT and ICD coding for lab testing.
Payer-specific billing for diagnostic laboratory services.
Denial prevention through accurate claim documentation.
Revenue optimization for high-volume laboratory operations.
Let's Get In Touch
Please fill up the form, one of our AAPC certified medical biller & coder will reach out to you
Laboratory Departments & Services We Support
Explore accurate billing and coding services built for diagnostic and clinical laboratories.
Numbers That Tell Our Story
” BEHIND EVERY STAT IS A MILESTONE WE ARE PROUD OF “
IN BUSINESS
CLAIMED PROCESSED
REDUCTION IN AR
REVENUE IMPROVEMENT
FIRST PASS CLAIM RATE
Laboratory Revenue Instability Across
Multi-State Operations
Medical Necessity Disputes In States
In California, a regional laboratory began seeing consistent denials from commercial payers citing lack of medical necessity, even when ordering physicians followed standard diagnostic protocols. At the same time in Massachusetts, Medicare contractors requested repeated documentation for routine panels, delaying payment cycles. Providers assumed the issue was payer-driven, but reviews showed diagnosis codes were not aligned with state-specific coverage determinations. Evocare Billings mapped payer LCD and NCD rules by state, corrected diagnosis-to-test alignment before submission, and ensured ordering documentation supported coverage criteria. This reduced denials, shortened review timelines, and improved reimbursement consistency without altering clinical ordering behavior.
Post-Payment Audit Exposure In Markets
In Illinois, a laboratory faced unexpected recoupments after payer audits flagged unbundled tests billed separately over several months. In Nevada, similar audits questioned frequency limits for repeat testing, resulting in revenue reversals long after payment. These post-payment adjustments disrupted cash planning and eroded trust in financial reports. Evocare Billings analyzed historical billing patterns, corrected frequency and bundling logic, and implemented pre-bill audit checkpoints. By adjusting submission behavior proactively, labs reduced audit triggers, stabilized net collections, and protected revenue already earned.
Improve Laboratory Billing Accuracy & Speed Up Reimbursements
Laboratories often experience payment delays due to medical necessity reviews, payer-specific coding rules, and post-payment audits; our laboratory billing services ensure accurate test coding, diagnosis alignment, and compliance with Medicare and commercial payer policies, reducing denials, limiting audit risk, and accelerating reliable reimbursements across multi-state operations.
Laboratory Billing & Coding Services For
Accurate & Faster Reimbursements
Ensure compliant test coding, diagnosis alignment, and timely claim submission to reduce denials.
Real-time verification that prevents rejections & secures faster payments.
Fast, accurate credentialing that gets your providers enrolled & billing without delays.
Patient-focused CCM programs that improve outcomes & generate recurring revenue.
Skilled virtual assistants who simplify clinical tasks & boost provider productivity.
Efficient front desk operations improving accuracy, workflow, & patient satisfaction.
Real-time verification that prevents rejections & secures faster payments.
Fast, accurate credentialing that gets your providers enrolled & billing without delays.
Patient-focused CCM programs that improve outcomes & generate recurring revenue.
Skilled virtual assistants who simplify clinical tasks & boost provider productivity.
Efficient front desk operations improving accuracy, workflow, & patient satisfaction.
Billing Without Hassle!
Streamline Your Workflow & Boost Productivity With Our Innovative Solutions.
EHR’s We Work With
Evocare Billings Keep Your Billing Flawless & Fully Integrated – No Matter Which EHR or EMR Your Practice Runs On
Hear From Our Clients
From Struggle To Streamlined — Their Words, Our Wins, & Voices Of Success.
Increase Collections With Laboratory Billing Solutions
Laboratories face reimbursement challenges from medical necessity reviews, payer-specific coding rules, and post-payment audits. Our laboratory billing solutions, led by experienced AAPC-certified CPC and CPB professionals, ensure accurate test coding, proper diagnosis alignment, and compliant claim submission—reducing denials and payment delays.
Our certified team streamlines laboratory revenue cycles, improves first-pass claim acceptance, and maintains CMS and payer compliance. This helps laboratories achieve faster reimbursements, reduced administrative effort, and consistent cash flow across operations.
Let's get in touch
Please fill up the form, one of our AAPC certified medical biller and coder will reach out to you
Frequently Asked Questions
If You Can’t Find The Answer You’re Looking For, That’s No Problem. Schedule a Demo, & We’ll Work To Answer Your Question.
What Is Laboratory Billing And How Does It Work?
Laboratory billing involves submitting claims for diagnostic tests such as blood work, pathology, molecular testing, and toxicology. Claims must include accurate CPT codes, correct diagnosis linkage, and ordering provider information. Billing rules vary by Medicare, Medicaid, and commercial payers. Errors often result in denials or delayed payments.
What Are The Most Common Billing Challenges For Laboratories?
Laboratories frequently face denials due to medical necessity issues and diagnosis-to-test mismatches. Missing ordering provider documentation is another common problem. Post-payment audits and recoupments also pose financial risk. These challenges can significantly increase accounts receivable days.
How Can Laboratories Reduce Claim Denials And Delays?
Denials can be reduced by ensuring proper diagnosis coding aligned with payer LCD and NCD policies. Verifying ordering provider credentials before submission is critical. Pre-submission claim validation helps catch errors early. Consistent billing workflows improve first-pass acceptance rates.
Which CPT Codes Are Commonly Used In Laboratory Billing?
Laboratories bill CPT codes for clinical pathology, anatomic pathology, molecular diagnostics, and toxicology testing. Many codes are subject to payer-specific coverage and frequency limits. Incorrect code selection often triggers denials or audits. Specialized lab billing expertise is required for accuracy.
How Do Medicare And Commercial Payer Rules Differ For Laboratory Billing?
Medicare applies strict medical necessity and frequency guidelines based on LCDs and NCDs. Commercial payers often follow their own medical policies and authorization rules. Documentation requirements may vary significantly. These differences increase billing complexity for multi-payer laboratories.
Should Laboratories Outsource Medical Billing Services?
Outsourcing laboratory billing helps manage complex payer rules and audit exposure. Specialized billing teams reduce denials, underpayments, and recoupments. Laboratories save administrative time and improve cash flow. This allows labs to focus on testing quality and operational growth.
Get paid faster with 24/7 expert medical billing support
Seamless integration with your EHR for smooth workflow operations
Trusted nationwide for a 99% client retention rate
