How we can help
A practical plan.
A shared understanding.
Requisitions and ordering providers
Labs usually bill for tests someone else ordered, so a lab claim depends on its requisition: the ordering provider, the tests ordered and the diagnosis behind them. When something is missing, it has to be resolved with the ordering office before the claim goes out.
Medical necessity
Many tests are paid only when the diagnosis supports them, and Medicare’s coverage determinations list the diagnoses that support many common tests. When Medicare may not cover a test, an Advance Beneficiary Notice (ABN) signed before the test lets the lab bill the patient if Medicare denies it.
Denials and follow-up
With many claims a day, a small error repeats quickly. Work denials to their cause, follow up on unpaid claims, and track the patterns so they can be fixed where they start.
Start by agreeing on the scope.
We’ll discuss your existing systems, the work your team handles, and the support you want from Highview. Services, access, reporting and commercial terms are agreed before work begins.
Common questions
Good to know
before the call.
How is this different from your medical billing service?
A lab rarely sees the patient or writes the order, so lab billing leans on requisitions, ordering providers and the coverage rules for each test. Medical billing describes our claims workflow in general.
Do you need patient records to start?
Not for the first call. Records are shared only after a business associate agreement (BAA) is signed and a secure process is agreed. Please don’t send patient information through the website.