Clinical Laboratory Billing


Clinical laboratory billing is under intense scrutiny. The Office of Inspector General announced its intention to closely review independent clinical laboratory billing practices, and recommended that the Centers for Medicare & Medicaid Services increase oversight of clinical laboratory services. With reimbursement tightening and costs for clinical labs increasing, the need for compliant, proficient clinical lab billing has never been greater.

PGM understands the ever-growing, ever-changing challenges facing today’s clinical labs. Billers and coders must have knowledge of the extensive types of services a clinical lab may provide (e.g. biological, serological, hematological, cytological) and the rules for in- and out-of-network billing. They must maintain familiarity with the latest medical technology, CPT and ICD-10 codes, and understand what is required to ensure claims support medical necessity. But the margin for error is slim. Labs cannot afford to leave money on the table or waste time battling denials. That’s why clinical labs throughout the country trust PGM with their medical billing.

PGM has more than 30 years of experience with clinical lab billing, and has developed one of the nation’s most effective laboratory billing and coding services. These services are customized for every engagement to meet the needs and objectives of your practice. Our team of laboratory billing specialists and AAPC-certified coders will work closely with you to deliver best-in-class billing practices and procedures.

To learn more about our clinical laboratory billing services, request a free demo or contact us for more information.

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    Best-in-Class Medical Billing Software &
    Services for Healthcare Professionals

    Proof in Numbers

    • 8% average improvement in collection, growth adjusted
    • $1 billion in gross claims billed annually
    • 61 million accessions/visits processed annually
    • Up to a 50% reduction in denials
    • Two-time increase in successful appeals
    • 100% payor reach
    • Reduced Billing costs based on collections not payroll
    • 39 year track record
    • Over 30 specialties
    • Serving all 50 states

    Laboratory Revenue Cycle Management

    MedicalCoding ChargeUpload ClaimAudits ClaimSubmission PaymentPosting PaymentTracking DenialManagement PatientBalances Reporting

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