Genetic testing is a medical test that analyzes a person’s DNA to identify changes or variations in their genes that may cause or increase the risk of developing a certain medical condition or disease. This type of testing can be used to diagnose genetic disorders or to determine an individual’s risk for inherited diseases such as cancer, Alzheimer’s disease, or heart disease.
Genetics has greatly evolved over the past few years with labs becoming an industry staple for everyday health and wellness. It has become an increasingly important and effective tool in identifying and treating disease.
Genetic testing confirms or rules out genetic conditions as well as determine whether a person can pass those conditions onto their offspring. This helps clinicians focus on the correct treatment as quickly as possible which leads to better health outcomes for patients.
Most insurers now require that the appropriate ICD-10 codes and authorization be on file prior to a claim being submitted. Without such prior documentation and DX codes, those claims will be denied.
That’s why we offer medical billing services to help you through this ever-changing maze of billing codes (especially, understanding which CPT codes are used in genetic testing billing) and procedures. We are also pleased to offer credentialing services to let you focus more on your core business than the mounds of paperwork to complete the process.
Genetic Testing Billing
Let the specialists at Medwave help organize for all the requirements essential to getting your claims paid sooner, every time. Our team is quite proficient and has the know-how in the medical billing and coding needs of genetic testing lab specialists and has firsthand experience working with both commercial and government insurance firms to get your claims paid fast and efficiently. You can be assured our end-to-end laboratory billing services provides maximum reimbursement while reducing overall costs and time to payment.
The value offered to genetic testing labs includes:
Complete Solution
We totally take care of your billing. Your staff will no longer have to perform data entry, amend claims or contact patients to collect money. Moreover, we believe rejection and denial processing is what sets great billing companies apart from the run-of-the-mill, ordinary billing company. That’s why Medwave never overlooks an opportunity to appeal an insurance rejection to make sure your lab gets paid properly and quickly.
Increasing Client Revenue
Medwave has assisted our medical laboratory clients in boosting their monthly income via superior billing performance by our team of highly trained experts. We also proactively notify your lab on fee schedule developments and can help with contracting if required.
Reduce In-House Staff
Employ Medwave and allow us to be your billing staff. You’ll no longer have to be concerned with taxes, vacation/sick leave, payroll or personnel supervision when you work with us. Even should you choose to maintain some of your current billing staff, but shuffle their responsibilities, you can be confident in knowing that your billing is being managed expertly and attended to each day.
Transparency
Even when you outsource to experts, you still need to know what’s going on with your medical lab claims. A well-thought-of and reliable lab billing company such as Medwave will provide you regular reports that make known what they’ve been doing for your lab and where you stand with claims. There’s no need for you to micro-manage, however, you do want to at least keep an eye on the billing to ensure it’s being taken care of efficiently.
Security
Patient privacy is essential to your lab’s success, not only because you’re maintaining a business and your clients are entrusting you with their confidential information. But you also must obey federal and state privacy laws, such as HIPAA rules and regulations. Medwave is a trustworthy provider of lab billing services, one that takes security as seriously as you do.
Genetic Testing Billing FAQ
What is genetic testing used for in a medical setting?
Genetic testing analyzes a person’s DNA to find changes or variations in genes that may cause or raise the risk of a medical condition. It is used to diagnose genetic disorders and to determine a person’s risk for inherited diseases such as cancer, Alzheimer’s disease, or heart disease. It also helps confirm or rule out whether a condition could be passed to offspring, guiding clinicians toward faster, more accurate treatment.
Why do genetic testing claims get denied by insurers?
Most insurers require the correct ICD-10 codes and prior authorization on file before a claim is submitted. If that documentation and the diagnosis codes are missing, the claim will be denied. Medwave’s billing services are built to handle these coding rules and CPT code requirements specific to genetic testing so claims are submitted correctly the first time.
What billing services does Medwave provide for genetic testing labs?
Medwave handles the full billing cycle for genetic testing labs, including data entry, claim submission, amendments, and patient billing contact. The team also focuses heavily on rejection and denial processing, appealing insurance rejections so labs get paid properly and without unneeded delay. This covers both commercial and government insurance claims.
Does Medwave offer credentialing services for genetic testing providers?
Yes, Medwave offers credentialing services alongside its billing support for genetic testing labs. This lets lab staff focus on their core diagnostic work rather than the paperwork tied to enrollment and credentialing with insurance payers. It is part of a broader effort to reduce administrative load on lab teams.
How can outsourcing billing help increase revenue for a genetic testing lab?
Medwave has helped medical laboratory clients raise their monthly income through more accurate and consistent billing performance from a trained team. The company also monitors fee schedule changes and can assist with payer contracting when needed. This proactive approach helps labs capture revenue they might otherwise miss.
What happens to in-house billing staff when a lab outsources to Medwave?
Labs can choose to reduce their in-house billing staff and let Medwave manage the billing function, removing concerns like payroll, taxes, and staff supervision. Labs that want to keep some staff can shift their responsibilities while Medwave manages the daily billing work. Medwave also provides regular reports so labs stay informed on claim status and billing activity even while outsourcing.
Why Genetic Testing Professionals Choose Medwave for Billing & Credentialing Services
Credentialing refers to medical or insurance credentialing, as both are used interchangeably. Healthcare providers, including medical laboratories, who wish to bill an insurance company as an in-network provider must undergo a process of credentialing.
At Medwave, we offer a team of medical laboratory credentialing professionals committed to serving all your credentialing needs. From gathering relevant information to filing claims and following up with insurance companies, our specialists hand the entire credentialing process, allowing you to focus on your medical lab as a healthcare provider.
We recognize that credentialing is a time-consuming process. That’s why our credentialing team possesses the experience and know-how to get medical laboratory credentialing done quickly and efficiently. Our credentialing service includes such essentials as provider enrollment and primary source verification. The following post, Credentialing (On-Board Process for Providers, Facilities) elaborates our overall process in greater detail. In other words, we do everything from A to Z to get you approved.
Medwave credentialing benefits include:
- We keep all your credentialing information in one place.
- We possess years of experience to navigate through the processes of Medicare and Medicaid provider enrollment, commercial insurance provider enrollment and other healthcare provider credentialing needs.
- Our status reports on progress of credentialing keep you up to date.
- Our application collection resources are among the best in the industry.
- Our application completion includes ongoing monitoring.
- Finally, our medical credentialing is perhaps most important because it’s the one method that permits patients to place their trust with utmost confidence in their chosen healthcare providers.
We could go on, but we’d rather you give us a call to make an appointment so we can properly demonstrate what Medwave can do to streamline your billing and credentialing processes, save you time and money, and put to bed those internal billing and credentialing headaches.
Our staff is here to help you and your office succeed in preparing claims and getting reimbursed. Contact us below to see how we can be the best asset to your genetic testing coverage and reimbursement endeavor.