- +1 (773) 985-1869
- info@stream-rcm.com
- 14430 Ocean Point, El Paso, TX 79938
Stream RCM is a billing company for laboratories offering services to clinical, molecular, pathology, and toxicology labs. Our professional team of certified coders and billers handles the tasks of charge capture, claims filing, denial management, and insurance follow up. We know how to code in accordance with CLIA regulations and insurance medical necessity guidelines.
We are a committed team of laboratory billers with diagnostic coding experience, payer negotiations, and compliance knowledge to increase your revenue.
Our services are available to independent laboratories, hospital out-reach programs, and reference laboratories. Our coders will be coded based on their disciplines of chemistry, microbiology, molecular, and pathology. Panel packaging, medical necessity, and payer guidelines are managed well.Claims remain clean so your lab remains financially stable.
We give you customized solutions for each aspect of laboratory medicine. It’s our way of making sure that everything we do is precise and compliant as well as financially successful.
Our billing process is careful with regards to chemistry panel volumes to ensure that frequency edits and bundling guidelines are followed to maintain clean claims for metabolic and lipid tests.
Our coders provide exact molecular and genetic test codes, demonstrate medical necessity effectively, and ensure that prior authorization is handled, when necessary, by many insurers for these services.
We monitor culture, sensitivity, and reflex testing sequences in order to bill each part properly without getting duplicate or unbundling denials by commercial insurers.
We code specimen complexity and professional interpretation components accurately to ensure that the documentation is consistent with payers’ requirements for pathology specific reimbursement.
We handle the increased scrutiny for toxicology claims by using appropriate coding and proper documentation to reduce denial for medical necessity and frequency requirements.
The profitability of your lab relies on these six services operating harmoniously. Stream RCM has ownership of all six, starting from initial eligibility verification all the way to the end where claims are unpaid.
Accurate CPT, ICD-10, and HCPCS coding by our trained coders specializing in laboratory test coding, resulting in claim approval on the first try.
Our claim scrubbing identifies any mistakes and improves the chances of payment using payor guidelines prior to claim submission.
We do a vigorous effort at determining the root cause of problems and quickly appealing denial to recover revenue and avoid repeat occurrences.
Our process for working aged accounts receivable is done on a set schedule so that claims never sit idle beyond the point of no return for filing them on time.
We take care of the enrollment and re-credentialing process for the payers, thus making sure that your lab can bill for everything without any disruptions.
By analyzing actionable data with the use of customized dashboards, we are able to identify denial trends, payers' performance and overall revenue cycle performance.
Meet the laboratory billing company that treats your revenue cycle with the precision it deserves.
In the field of laboratory finance, where each choice can have serious consequences, the choice of outsourcing is crucial. Internal billing teams find it difficult to catch up with frequent changes in the payer’s policies and complex codes, which results in lost revenue and problems with compliance. Stream RCM can offer you a unique, comprehensive solution that will help your business. When you outsource laboratory medical billing services to our company means that you will be able to get rid of administrative responsibilities, use the skills of experienced lab billers, and achieve financial predictability.
Our certified coders are experts in applying the most complex and frequently audited procedure codes for laboratory services.
| CPT Code | Common ICD-10 | Stream RCM Coding Approach |
|---|---|---|
| 80061 (Lipid Panel) | E78.00 (Pure hypercholesterolemia) | Our services guarantee proper medical necessity linking and panel coding for prevention of partial denials. |
| 80307 (Drug Screen) | F19.10 (Other psychoactive substance abuse) | We avoid improper billing by not coding both presumptive and definitive tests on the same day, without medical necessity. |
| 81275 (KRAS gene) | C18.9 (Malignant neoplasm of colon) | We manage MolDX Z-Code requirements to achieve full coverage of oncology molecular diagnostics. |
| 87426 (Infectious agent antigen) | J12.9 (Viral pneumonia) | The members of our team make sure that we use the right modifiers and bill only for the reimbursable syndromic panels. |
| 88305 (Pathology tissue exam) | D48.1 (Neoplasm of connective tissue) | Our experts use the appropriate professional and technical billing elements for pathology services. |
Genetic testing becomes more widespread, the issue of getting reimbursement continues to be difficult. The payers may not have uniform coverage guidelines and would require proper medical necessity information. We take away the difficulty. Our team of professionals is expert in handling the MolDX procedure, taking care of Z code guidelines and understanding the details of the payer policies for test procedures such as NIPT and oncology panels. We take on the responsibility of prior authorization and documentation assessment, so that these expensive but essential tests are properly reimbursed.
Stream RCM fits into your current laboratory workflow, with no double data entry and disruption of your processes to make sure that all claims are accurate, timely, and properly supported.
As a result of telehealth services, there have been new challenges associated with billing in laboratories. Test orders made through telehealth appointments must be incorporated into your billing process efficiently. Here at Stream RCM, we handle the entire process in ensuring that test orders from telehealth providers are linked with the laboratory’s billing system. This is made possible by our efficient coordination and documentation processes to ensure that tests made from these providers are billed appropriately.
Repeating patterns of denials in the independent laboratories and hospitals outreach laboratories throughout the country. Our professionals are here to solve it.
We are your strategic partner committed to ensure the financial prosperity of your laboratory.
Our whole team understands the details of laboratory billing, offering an expertise level that cannot be matched by generic medical billing companies.
We provide total visibility for you into your billing process through transparency in all of our operations and communications.
You get a high-quality service for a reasonable price that will help you lower your administrative costs and increase your income.
It is not only about dealing with denials but also preventing them from happening. We have an analytics-based approach that eliminates any problem before it occurs.
Our certified coders handle PLA and MolDX Z-codes, manage prior authorizations, and validate medical necessity.
We scrub claims against payer-specific rules before submission, then root-cause and appeal any denials quickly.
Yes, we handle credentialing and enrollment with Medicare, Medicaid, and commercial payers for your lab.
We provide monthly reports tracking denial rates, days in A/R, claim status, and payer performance.
Labs typically see denials drop, A/R days fall 20-30%, and strong ROI within just months.
Compare your current results against proven lab billing solutions built specifically for clinical labs today.
