Pathology rcm
Maximize Accuracy.
Drive Efficiency.
Transparent, results-driven pathology revenue cycle management (RCM) solutions.
Pathology practices face numerous challenges in managing operations—from declining reimbursements and complex billing requirements to insurance denials and out-of-network payment issues. Health Prime alleviates these struggles by offering comprehensive, technology-enabled RCM solutions that streamline billing and coding processes, reduce denials, and maximize reimbursements.
Why Health Prime?
We do more than manage your revenue cycle—we optimize it to drive better financial outcomes and operational efficiencies for your practice. With the acquisition of AdvantEdge Healthcare Solutions, our 50+ years of experience and the trust of thousands of pathology providers, we are a true partner in your success. Unlike other RCM partners, we employ all our staff and offer a dedicated customer success team, ensuring accountability, expertise and excellence in every service aspect.
Pathology billing results you can expect
Faster Claims Submissions
Reduced
Denials
Increased Net Collections
Cash Flow Predictability
"Health Prime does a great job for us: strong collections, excellent A/R results, and responsive service. We highly recommend Health Prime to other pathology practices.”
Core Operational Pillars
Coding: Certified coders, audited monthly with a mandatory, minimum accuracy of 95%. CPT, ICD-10 and specialty-specific MIPS measures.
Compliance: Documented and extensive compliance plans, annual mandatory continuing education, proven workflows, SOC I and SOC II audits, OIG risk assessments, and safeguards for HIPAA and HITECH.
Security: VPN access, data redundancy, hardened data centers, encryption layers, multifactor authentication, US housed data, documented security and recovery plans, and cyber insurance coverage.
Technology: Machine learning, artificial intelligence (AI) where appropriate, 6+ patient bill pay methods and 24/7 operational metrics via actionable Datalytics dashboards.
Patient Support: Advanced call center providing key metrics including volume, time to answer, time to resolve and satisfaction. Multilingual support and the ability to handle all US time zones.
Health Prime Datalytics
Our Business Intelligence platform provides 24/7 web access to your operational metrics, offering real-time insights and data-driven decision-making. We monitor a wide range of KPIs with laser-focused attention, offering actionable insights to ensure your practice’s financial health.
-
Simple interface, powerful insights
-
Drill down capabilities all the way to the CPT level
-
Point and click visual and numeric data views
-
Historical and forecast data views with industry targets and benchmarks
-
KPI summary views with alerts to identify any out-of-range exceptions
-
Easily exportable results
