Pathology‑Specific Charge Capture
- Surgical pathology logging (specimen adequacy, block/part counts)
- IHC panel settlement (stain vs. interpretation matching)
- Molecular test tracking (81479 unlisted codes)
Specialized billing solutions for pathology labs and diagnostic centers to minimize claim denials, streamline coding accuracy, and maximize timely reimbursements.
Pathology practices are not comparable to other specialties in terms of their technical vs. professional component splits, high laboratory volumes, Medicare technical fee schedules, and payer-specific requirements regarding surgical pathology, cytopathology, and molecular diagnostics.
Acuity Health Solutions provides pathology medical billing services in the United States that assist pathology groups and independent labs to maximize reimbursements by ensuring accuracy in coding and denial avoidance. Being the leading pathology billing company in USA, we offer a multifaceted pathology RCM service as an anatomic, clinical, and molecular pathology workflow.
Pathology billing demands experience in various sources of revenue and payer specifications:
Lab processing charges (CPT 88300-88309 surgical pathology) Automated IHC staining (88342-88344) Flow cytometry (88182-88185) Molecular diagnostics (81403-81479)
Pathologist interpretation (‑26 modifier) Gross description documentation Microscopic evaluation levels
Medicare MPFS: Pathology technical prices are limited by PFS. Private payers: Differing reimbursement of Level IV/V surgical pathology. Hospital‑lab splits: 60/40 revenue sharing agreements
Our pathology RCM service has a well-organised workflow that is optimised to bill a high number of lab results:
Certified pathology coders manage:
TC/PC Split Accuracy: 99.5% modifier compliance
Common Pathology Denials We Fix:
Pathology Medical billing services in the USA for hospital-based and reference labs handling surgical specimens, frozen sections, and cytopathology.
Management of chemistry, hematology, microbiology and coagulation panel pathology revenue cycle.
Specialty pathology RCM service to NGS panel, companion diagnostics, and hereditary cancer testing.
Billings’ research grants, Autopsy, and case coordination.
Key Metrics Achieved:
Epic Beaker, Cerner CoPath Sunquest, PowerPath Custom HL7 interfaces for specimen tracking
Claim status by specimen type Analytics on TC/PC revenue split. CPT Code payer performance.
The Acuity Health Solutions is the best solution to the top pathology medical billing services in USA denials:
The majority of the most Frequent Pathology Denials:
Outcome
82% denial recovery rate, which saves A/R days by 25-30 days throughout the pathology groups in the country. Our pathology RCM service converts the denials into a revenue loss into a revenue recovery.
Free pathology billing performance: Introduce yourself to a free analysis of your 10 most frequently used CPTs, denial rates, and payer mix. Live within 30 days.
“I have worked with this medical billing company since its inception, and I could not be more pleased with the service they provide. Their attention to detail, responsiveness, and commitment to personalized, one-on-one support are truly unparalleled.Having previously worked with several different medical billing companies, I can confidently say that none has come remotely close to the quality, reliability, and individualized service this team consistently delivers. I have referred multiple colleagues to them without hesitation, and I will continue to do so.I could not recommend them more highly. Exceptional service from an exceptional company—A+!”
Amerson Pegram, MD
Eyesthetics
“Working with Acuity Health has been an exceptional experience. Their team is incredibly knowledgeable, professional, and genuinely committed to helping our practice succeed. They make even the most complicated processes feel seamless, keep everything running smoothly behind the scenes, and are consistently responsive whenever we need support. Their expertise and reliability allow us to focus on caring for our patients and growing Ravora Health with confidence. We truly could not do what we do without them and would enthusiastically recommend Acuity Health to any healthcare practice looking for a knowledgeable, dependable, and dedicated partner.”
James Nguyen & Juliet Chhor
Ravora Health
“Credentialing was one of those areas that was constantly taking time away from our internal team. Since Acuity took it over, it has been much easier for us to keep track of where everything stands. Matthew has been very responsive whenever we have questions, and Priya has been great about following up with the insurance companies and letting us know when something is still pending. We no longer feel like we have to chase every application ourselves.”
Lane Holbrook, DO
Pocahontas Memorial Hospital
“The biggest compliment I can give Acuity is that I don't feel like I need to manage them every day. Matthew checks in when something genuinely needs our input, John gives us a clear picture of what is happening with billing, and the backend team handles most issues without creating additional work for our office. Over time they have learned our preferences and how we like things handled, which is exactly what we wanted from an RCM partner.”
Dean Kubacz, MD
Bonner General Family Practice
John Castro
John Castro has 16 years of experience in U.S. medical billing and Revenue Cycle Management. His expertise includes claims, denial management, accounts receivable, client coordination, and healthcare operations.
Zayn Harrington
Zayn Harrington has over 8 years of experience in Revenue Cycle Management. His expertise includes eligibility and benefits verification, pre-authorization, pre-determination, payer coordination, and reducing billing issues and claim denials.
Priscilla Steve
Priscilla Steve has 10 years of experience in Revenue Cycle Management. Her expertise includes accounts receivable, denial management, claim follow-up, appeals, underpayment resolution, and outstanding balance recovery.
EHR Systems We Support
We optimize technical and professional component billing, coding accuracy, and payer workflows to reduce denials and accelerate reimbursements.