Medical Billing / RCM | Laboratory
For independent labs with ~$4 million in annual collections, revenue cycle management (RCM) isn’t just an operational function, it’s a strategic decision point. With new mandates, billing pressures, and now legislative shifts ahead, lab leaders must ask: Is our billing setup ready for 2026?
With the impending 2026 Medicare fee cuts and new CMS mandates, safeguarding your practice’s financial health has never been more important.
The Importance of Patient Engagement: Why They - And You - Need It
Learn why patient engagement is a necessity and how you can master it within your practice.
Why the Revenue Cycle Is the Heart of Healthcare Profitability The financial health of any healthcare organization depends on one core process: Revenue Cycle Management (RCM). It’s the system that connects patient care to reimbursement—and when it runs efficiently, your organization thrives. When it doesn’t, you face rising denials, longer payment delays, and cash flow uncertainty.
Why RCM Is the Unsung Hero of Healthcare Every healthcare provider and stakeholder knows the frustration: you deliver excellent care, document meticulously, submit a claim, then wait weeks (or months) for payment—only to face denials or underpayments. Multiply that across hundreds or thousands of patient encounters or lab tests, and the problem becomes clear: without a strong Revenue Cycle Management (RCM) system, financial stability is impossible.
Let’s start with what we know will happen overall, podiatric coding-wise, in 2026.
A Year That’s Testing Every Lab’s Financial Model Halfway through 2025, many diagnostic and clinical laboratories are facing a strange paradox. Test volumes remain healthy—or even rising—yet revenue is trending downward. This gap isn’t just frustrating; it’s a warning sign that familiar revenue-cycle levers no longer work in today’s reimbursement environment.
The Clock Is Already Ticking The next round of PAMA reimbursement cuts takes effect in 2026, but the data that determines those rates is being collected throughout 2025. That means the decisions you make this year—how you map payers, report rates, and validate contracts—will directly shape your revenue through 2029.
Sources: American Academy of PAs (AAPA), NBC News Health | www.adsc.com
Why Billing Is So Difficult for Therapists For most therapists, billing is the part of the job that feels least like “therapy.” You didn’t get into this field to chase down prior authorizations, decipher claim adjustment codes, or appeal denials that make no clinical sense. Yet without an effective billing system, the financial stability of your practice—and your ability to keep serving clients—is at risk.
Few issues create more frustration for providers than prior authorization (PA). It delays care, creates administrative headaches, and slows down reimbursement. In 2026, prior authorization reform will reshape both Traditional Medicare and Medicare Advantage (MA) in ways that every practice and laboratory needs to prepare for.