Lab Denials/ Prior Authorizations for Labs

Labs have unique struggles when it comes to “no authorization” denials. Busy physicians order lab tests— but may not jump through all the hoops required to obtaining the prior authorizations necessary for payment. Often, authorization may not be obtained prior to, or at the time the lab collects a specimen. This puts labs in the position of fighting denials after the fact—just to get paid for services they already provided.

 

Why do outpatient labs seek THG Consulting’s assistance? Because

• We have hard-to-find expertise.
• We specialize in obtaining retroactive authorizations for

labs.
• Our company has a strong record of successful appeals.

How do we do it? We tackle claims on a payer by payer basis. Labs count on us to dig deep into payer guidelines and the write compelling appeals necessary to get paid.