PAMA Pricing Compliance
Medicare Clinical Lab Fee Schedule compliance and annual PAMA rate updates.
Clinical laboratory billing has more compliance landmines than almost any other specialty. PAMA pricing, Local Coverage Determinations (LCDs), Advance Beneficiary Notices (ABNs), and Medicare's complex coverage rules require a dedicated specialist — not a generalist biller.
Medicare Clinical Lab Fee Schedule compliance and annual PAMA rate updates.
Local Coverage Determination review for every claim before submission.
Automated ABN workflow to protect against non-covered test write-offs.
Diagnosis code review to confirm medical necessity for each test.
Proper billing for reflex and add-on testing.
Correct billing for reference lab tests ordered through your facility.
We learn your specialty, payer mix, volume, and current billing challenges. 15 minutes — no fluff.
DAY 1We connect to your existing EHR or PM system. No new software. No disruption. Setup in under 48 hours.
DAYS 2–3We review 30 days of prior claims, identify denial patterns and coding gaps, and set your performance baseline.
DAYS 3–5First claims go out within 24 hours of your first patient day. Dashboard is live. Your account manager is reachable.
DAY 5+Within 60 days our denial rate dropped from 18% to 4%. I was honestly skeptical — we had been burned by a billing company before. But the numbers don't lie. Collections are up $28,000 per month.
Dr. Michael TorresInternal Medicine, Phoenix AZ+$28K/month in collections
The onboarding was seamless. Day 5 we were live. Our previous biller took 6 weeks to get going. RCMBillers had us processing claims faster than I thought was possible.
Jennifer Choi, MBAPractice Administrator, Orthopedic Group, Seattle WALive in 5 days vs 6 weeks prior
They found $60,000 in undercoded services in the first month. No new patients, no new staff — just correct billing. I wish we had switched years ago.
Dr. Aisha PatelGastroenterology, Atlanta GA$60K found in Month 1 coding audit
+ 488 more payers. If they pay claims, we know how to bill them.
Every piece of protected health information (PHI) we handle is secured under full HIPAA compliance — administrative, physical, and technical safeguards in place at every level.
We maintain comprehensive Business Associate Agreements with every client. Our staff undergoes annual HIPAA security training, and all PHI transmission uses 256-bit encryption.