Billing for pathology is not general billing with a different code set. Specimen-level coding, where the unit of billing is the specimen rather than the encounter.
Frequently billed as a non-treating provider, which makes patient demographic accuracy entirely dependent on the referring practice.
At a glance
What drives the coding
Specimen-level coding, where the unit of billing is the specimen rather than the encounter.
What drives the payer behavior
Frequently billed as a non-treating provider, which makes patient demographic accuracy entirely dependent on the referring practice.
Coding
Assigned by certified coders from your documentation.
Reporting
Denials segmented by reason, payer, and provider.
Where pathology claims actually fail
- Specimen counts billed as a single unit
- Demographics received incorrectly from the referrer
- Medical necessity not supplied with the order
How we work it
We code from what your record documents and query you when it does not support a code, which in pathology is where most of the avoidable exposure sits.
Denials are worked by cause rather than in queue order, so the same failure stops recurring instead of being re-worked every month.
We keep the books. You run the business.
Categorization, reconciliation, month-end close, and clean financial statements — with nothing left for you to chase.
View pricingHow It Works
Review
We look at your current pathology denials and aging.
Scope
A written scope and price before any work starts.
Transition
Coding and submission move across without a gap.
Report
Denial causes reported monthly, segmented by payer.
Pathology — Frequently Asked Questions
Do you have coders who know pathology?
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Yes. All coding is performed by certified coders, and specialty assignment is deliberate — specimen-level coding, where the unit of billing is the specimen rather than the encounter.
Do you guarantee we will collect more?
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No, and nobody honestly can. Payment is decided by the payer. What we commit to is the process and the six numbers we report, which you can check against your own system.
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