Laboratory Medical Billing Services

Turn Every Test into Timely Reimbursement—Without Delays or Denials. From routine bloodwork to high-volume toxicology, our expert lab billing team knows how to code, submit, and follow up with precision. We help clinical, reference, and molecular labs get paid faster, cleaner, and with full compliance.

Common Lab Billing Pitfalls

From genetic testing and toxicology panels to routine blood work and molecular diagnostics, lab billing involves ultra-specific CPT codes, strict medical necessity rules, and payer edits that shift monthly.

The common issues that Lab and diagnostic centers in the USA face are:
Unbundled Panels: Billing individual test components (like separate CBC elements) instead of using bundled panel codes often leads to automatic denials.
Missing CLIA Numbers: Payers won't pay if your lab's CLIA number is missing or invalid—it's a must-have on every claim for most lab services.
High Volume = High Error Risk: Processing hundreds or thousands of samples daily leaves room for tiny coding or demographic errors that lead to considerable revenue losses.
Coverage Rules Vary by Test & Payer: One payer may require diagnosis codes A, B, and C for a vitamin D test—another may require completely different ones. Staying current is crucial.

How We Optimize Your Lab Billing

At Swiftcare Billing, we specialize in full-service laboratory billing solutions—maximizing reimbursements while keeping your lab compliant, efficient, and scalable.

Here is how we enhance billing and RCM tasks:
Accurate CPT & ICD-10 Coding: We use real-time coding logic to match test panels, avoid unbundling, and ensure the correct diagnosis links—leading to fewer denials and cleaner claims for clinical, pathology, and molecular labs.
Lab Compliance Expertise: We track and apply all regulatory data—CLIA numbers, NPI taxonomy, LOINC codes, and test modifiers. Whether you're billing Medicare, Medicaid, or commercial plans, our laboratory billing compliance team has you covered.
Rapid Eligibility & Coverage Checks: Before your lab even processes a sample, we run real-time VOB and test-specific coverage checks, reducing write-offs due to unauthorized tests or policy exclusions.
Custom Reporting Dashboards: See detailed analytics for each test type, referring provider, or payer. Find out which lab services generate the most revenue, where denials are trending, and how to improve margins instantly.

Lab Billing Services We Provide

Clinical & Reference Lab Billing

We handle high-volume lab billing for clinical and reference labs with precision—minimizing denials and maximizing clean claim rates.

Toxicology & Genetic Test Coding

Our certified coders specialize in complex toxicology and genetic test billing, ensuring accurate CPT code mapping and payer compliance.

COVID/Flu/RSV Test Billing

We streamline billing for COVID-19, influenza, and RSV tests, keeping you compliant with evolving CDC codes and insurance coverage updates.

Pathology & Histology Billing

From biopsies to tissue analysis, we manage all aspects of pathology and histology billing with expert CPT coding and documentation checks.

Molecular Diagnostics Billing

We manage the nuances of molecular lab billing—from NGS panels to PCR tests—ensuring accurate modifiers, diagnosis links, and payer-specific rules.

Prior Authorization & VOB

We verify test coverage in advance through rapid VOB and prior auth services, reducing claim rejections and patient disputes.

Claim Scrubbing & Appeals

Our lab billing team scrubs each claim for coding, compliance, and payer edits—and fights every denial with aggressive, data-backed appeals.

Smart Lab Billing Integrations that Work

We work directly with top-tier lab EHRs and billing platforms. We ensure seamless sync, smoother claims, and fewer delays. We integrate billing software like:

States We Cover

Whether you’re in a high-volume diagnostic lab in California or a physician-owned setup in New Jersey, we’ve got every region, license, and payer type covered.
We work in:

Alaska

Washington

Oregon

Idaho

Montana

North Dakota

Minnesota

Maine

Vermont

New Hampshire

Massachusetts

New York

Connecticut

Rhode Island

New Jersey

Wisconsin

South Dakota

Michigan

Wyoming

Pennsylvania

Ohio

Illinois

Indiana

West Virginia

Maryland

Virginia

Kentucky

North Carolina

Tennessee

Georgia

Alabama

Texas

Florida

California

Ready for Faster, Cleaner Lab Reimbursements?

At Swiftcare Billing, we don’t just file claims—we fine-tune your entire lab revenue cycle. From molecular testing to pathology, we handle the coding, compliance, edits, and appeals that keep your reimbursements flowing. Let’s stop write-offs before they start.

What types of labs do you specialize in billing for?

We handle billing for independent clinical labs, toxicology labs, molecular and genetic testing facilities, pathology groups, and physician-owned labs. Whether you run a high-volume COVID lab or a boutique histology practice, we tailor our service to your workflow.

How do you handle panel coding and unbundling issues?

We use payer-specific guidelines and CCI edits to ensure panels like CBC, CMP, or toxicology screens are coded compliantly. Our system flags unbundled tests before submission, reducing denials and payment delays.

Can you help us stay CLIA-compliant on claims?

Yes. We make sure your CLIA numbers, taxonomy codes, and applicable modifiers (like QW) are included where needed. We stay on top of the latest CMS and payer rules, so your lab stays audit-ready.

Do you support prior authorization and insurance verification?

Absolutely. We verify test coverage and patient eligibility in advance—especially important for high-cost genetic or molecular testing. Our team also handles all prior auth submissions and follow-ups.

Which lab billing software or LIS platforms do you support?

We’re compatible with Kareo, AdvancedMD, Epic, and many others. We integrate smoothly with most EHR and LIS platforms to streamline your RCM workflow.