Key Takeaways Payer scrutiny of toxicology lab billing has intensified significantly, with Medicare Administrative Contractors and commercial insurers applying stricter medical necessity and documentation standards. Definitive and presumptive drug testing require distinct coding approaches, and errors in distinguishing between them are among the most common sources of toxicology claim denials. Local Coverage Determinations vary by […]
Louri Roberts
Louri Roberts serves as the director of client services for Physicians Group Management. She has more than 20 years of experience in healthcare in areas including payer relations, revenue cycle management, operational consulting, laboratory development, and inspection and management. Prior to joining PGM, Louri served as the co-founder and chief operating officer of Peachtree Medical Billing, a leading provider of laboratory billing services throughout the United States. She received her BS in microbiology from the University of Georgia.
Posts by Louri Roberts
White Paper: Why Laboratory Billing Breaks Down (And How LIS-RCM Integration Fixes It)
Why Seamless Integration Between Your LIS and RCM Systems Is Essential for Lab Financial Success Clinical laboratory billing often breaks down when laboratory information systems (LIS) and revenue cycle management (RCM) workflows operate separately. This white paper explains why the disconnect occurs and how integration helps laboratories reduce denials and improve reimbursement. Executive Summary Clinical […]
‘I Saw the Sign:’ Indicators It’s Time for a Laboratory to Outsource Its Billing
Key Takeaways Declining laboratory collections despite stable or growing test volume often indicate coding gaps, underpayment issues, or ineffective follow-up within the revenue cycle. Rising denial rates in laboratory billing typically reflect medical necessity errors, payer policy misalignment, or inconsistent documentation processes. Compliance pressure around molecular diagnostics, toxicology testing, and genetic panels requires proactive oversight […]
7 Top Reasons Laboratories Outsourced Their Billing in 2025
Key takeaways: Laboratories increasingly outsourced their billing in 2025 due to payer complexity, rising denial rates, staffing shortages, and the need for stronger financial visibility. Specialized laboratory billing partners provide deeper expertise in laboratory coding, compliance, toxicology lab billing, and overall laboratory RCM performance. Outsourced billing empowers labs to focus on core operations while strengthening […]
The Pain Management Billing Outsourcing Checklist for 2026 (and Beyond)
As pain management practices head into 2026, the demands on accurate coding, denial prevention, and timely follow-up continue to grow. Rising documentation standards, stricter payor scrutiny, and the increasing complexity of interventional pain procedures have all pushed practices to reassess whether in-house billing is sustainable. For many, outsourcing revenue cycle management (RCM) has become an […]
Orthopedic Billing Services: Why Outsourcing to a Specialist RCM Partner Drives Growth
Every orthopedic practice faces a complex financial environment — global surgical periods, implant billing, payer policy changes, and documentation demands that can overwhelm even seasoned staff. A single missed modifier, coding oversight, or denied claim can quickly turn into weeks of delayed reimbursement. For orthopedic practice owners, administrators, and business office leaders, these challenges cut […]
Navigating PCR Billing: CMS vs AMA Guidance on Multiplex Testing
Billing for molecular (PCR) testing has become a critical area of focus for clinical laboratories, especially as the Centers for Medicare & Medicaid Services (CMS), Medicare Administrative Contractors (MACs), and the American Medical Association (AMA) offer overlapping — but sometimes conflicting — rules. Understanding the nuances of multiplex PCR billing under CMS/NCCI and AMA guidance […]
How to Choose the Right Billing Software for Labs
If you run a lab, you already know billing isn’t the fun part. It’s complicated, time-consuming, and full of opportunities for things to go wrong. The right billing software for labs changes that story. It automates the tedious stuff, catches errors before claims go out, and helps you get paid faster. But here’s the tricky […]
Top Laboratory Billing Companies: What to Look For
If you’re running a lab, you already know how complex and ever-changing the billing landscape can be. Reimbursement rules shift constantly. Coding gets updated. Payers deny claims for reasons that don’t always make sense. And the financial health of your lab can hinge on how well those claims are handled. That’s exactly why more laboratories […]
Solving the Top Challenges in Dermatology Billing
Efficient dermatology billing is vital to a practice’s financial health, yet it’s often complicated by payer rule changes, denied claims, and time-consuming prior authorizations. Without the right systems and support, even minor missteps can lead to lost revenue and delayed payments. In this article, we explore the top dermatology billing challenges and the solutions practices […]