Autonomous Laboratory Billing & Specimen Accessioning RCM
Eliminate manual requisition entry, automate electronic ABN checks at specimen collection, and stop CARC 16/96 diagnostic unbundling write-offs across commercial and Medicare lab claims.
Clinical laboratories operate on high-volume, low-margin economics where a single missing requisition field or invalid ICD-10 crosswalk can turn a profitable chemistry panel into an uncollectible bad debt. Commercial payers exploit Local Coverage Determinations (LCDs) to reject routine lipid panels (80061), CBCs (85025), and CMPs (80053) for lack of qualifying diagnostic medical necessity. TravaLabs unites automated digital requisition intake with autonomous electronic billing scrubs, validating patient insurance and Medicare LCD rules before specimen tubes are ever spun.
Key results
- < 2.1% — Laboratory Claim Denial Rate
- $420K — Recaptured Annual Diagnostic Margin
- 100% Real-Time — EHR Requisition & LIS Sync
- 0 Manual Hours — Autonomous ABN Digital Capture
Core capabilities
- Electronic Requisition & Order Digitization — Direct bi-directional HL7/FHIR integration with client EHRs (Epic, Cerner, athenahealth) eliminating paper requisition transcription errors.
- Automated Medicare LCD / NCD Diagnostic Validator — Real-time rule engine that validates ICD-10 medical necessity against regional Medicare MAC policies before specimen accessioning.
- High-Volume CARC Denial Scrubbing & ERISA Appeals — Automated 835 remittance parsing and electronic re-adjudication of CARC 16, 50, and 97 laboratory denials without manual biller intervention.
- Patient Digital Co-Pay & Deductible Collection — Automated text-message billing workflows with compliant Good Faith Estimates (GFE) that collect patient responsibility balances within 48 hours.
Frequently asked questions
Can TravaLabs integrate directly with Laboratory Information Systems (LIS)?
Yes. TravaLabs features native bi-directional interfaces for Orchard Harvest, Sunquest, Cerner PathNet, and custom API-driven LIS platforms, synchronizing test orders, accessioning numbers, and insurance billing data instantaneously.
How does TravaLabs handle Medicare Advance Beneficiary Notices (ABNs)?
Our mobile and web intake interface alerts phlebotomists in real time if an ordered test fails LCD medical necessity criteria, automatically prompting the patient to sign a compliant digital ABN before the blood draw is finalized.