RCM Features

Our Revenue Cycle Management team has decades of experience working in tandem with customers to reach optimum revenue for their laboratory. Our team helps is there to strategize and make informed decisions to maximize claim reimbursements and lower revenue leakage.

Laboratory Coding
and Billing

Our dedicated team of medical coders and billing experts maintains a library consisting of millions of claim processing rules that helps to ensure that you receive reimbursement for your claims in less time. We assure that this step will be more successful with our medical billing technology, in order to prevent increased risks of undercharging, overcharging, and post-payment audit.

The coded documents are forwarded to the charge entry team and before transmitting the claims to the insurance payers through the clearing house, the entered charges are audited by the quality assurance team to ensure a 'clean claim' is submitted.


Labgen RCM solutions enable benefit investigation prior to service, coverage validation prior to claim billing, and coverage determination for patients identified as self-pay. Electronic eligibility checking can be performed in real-time on an individual basis with near immediate response. In order to ensure the reimbursement, Labgen RCM team performs following tasks:

  • Eligibility and benefits verification
  • Patient data management
  • Prior authorization and pre-certification processing

Physician Credentialing and EDI Enrollment

Trust our credentialing experts to help you navigate the difficult process of provider credentialing and EDI enrolment.
Services we offer
  • Medicare and Medicaid provider credentialing and EDI enrollment
  • Commercial insurances (i.e. Aetna, BCBS, Cigna, Humana) provider credentialing and enrollment
  • Medicare and Medicaid revalidation
  • CAQH registration
  • Reimbursement issues and fee negotiation
  • Obtaining provider and facility license
Outsourcing benefits
  • Redemption from paperwork and endless applications
  • Receive more referrals
  • Get your claims processed and paid by the insurance companies faster
  • Dedicated project manager assigned to your project
  • Complete follow-up with the payers including phone-calls, e-mail, fax and submit all applications.
  • Daily and weekly updates on your on-going credentialing projects.

Patient Billing and Collection

A patient statement is generated and filed on a weekly or monthly basis, as per your business requirement. Our patient contact services improve patient satisfaction, while lowering your costs and increasing revenue.

We also provide financial counseling and payment plans to the patients, if they are unable to pay the invoice and ensure they keep a good relationship with clients and encourage them to come back.

  • Patient statement processing and mailing
  • Attentive and proficient patient call center
  • Payment plan set up and patient payment posting
  • Generate collection reports and share with clients for further action

AR and Denial Management

Our AR and Denial Management solutions categorize claim denials, analyze root cause, attain process improvement, and track progress. It can lower internal costs, increase collections, and improve your cash flow.

Our skilled staff identifies patient accounts that require follow-up and take the necessary action to collect unpaid/underpaid claims.

  • Perform status checks on higher dollar balances and identify issues proactively to reduce aging
  • Address all denials within a week and clearing house rejections within 48 hours
  • Receive daily audit report, review and correct errors, re-file the claims for reprocessing.
  • Dedicated appeals handling team to file multiple levels of appeal
  • Preparing and submitting the supporting documents for tests

Reporting and Business Analytics

Our reporting package contains monthly customized reports, including Key Performance Indicators (KPI) report and Sales Group Revenue Reports, offering a detailed picture of your practice's financial health and the length of your claim payment cycle. Our analytics give you the ability to assess your revenue cycle activity.

  • Labgen pre-formatted reports to measure your practice performance and highlight areas for improvement
  • Visual charts and graphs help identify trends and quantify impact.
  • Management and sales group reports
  • Analytics around productivity, worklists, revenue at risk, cost containment