Driving Success in Lab Billing

Lab Billing

Focus on patient care while we handle your lab billing with precision and reliability.

Transforming Lab Billing with Automation

At Med Karma, we don’t just manage revenue – we engineer lab billing success through cutting-edge automation, predictive analytics, and industry-leading compliance. We empower Independent Laboratories, Physician-Owned Labs, Toxicology Labs, and Long-Term Care Labs across the U.S. to transform their billing operations from reactive to proactive, manual to intelligent.

Our Mission

In today’s complex and fast-paced healthcare environment, labs can no longer rely on manual processes or fragmented systems. Our mission is to bring automation, transparency, and control into every stage of the laboratory billing lifecycle, delivering faster payments, fewer denials, and measurable ROI.

Business Impact We Deliver

Key Metrics	Average Improvement
Clean Claim Rate	↑ Up to 98%
Days in AR	↓ Reduced by 30–50%
Denial Rate	↓ Cut by 40% or more
Net Collections	↑ Boosted by 20–30%
Patient Collection Rate	↑ Improved by 25% via digital tools

What Sets Us Apart

1. AI-Driven RCM Platform for Labs

Our proprietary platform combines:

Artificial Intelligence (AI) for instant validation and workflow routing.
Machine Learning (ML) to identify denial patterns, anticipate claim issues, and adapt to payer behavior.
Robotic Process Automation (RPA) for handling repetitive tasks at scale, including EOB posting, rework routing, and patient outreach.

2. Real-Time Dashboards & Revenue Intelligence

Executive-level and detailed dashboards provide a clear view of claims, collections, denials, and payer trends.
Track key metrics in real time, including Clean Claim Rate, DSO, Net Collections, and Denial Recovery Time.
Custom alerts and drill-downs support effective operational decision-making.

3. Eligibility & Prior Authorization Automation

API integrations with clearinghouses and payer systems to perform instant eligibility verification.
Automated prior authorization workflows triggered by CPT/diagnosis rules and payer requirements.

End-to-End Lab RCM Automation Framework

RCM Stage	Automation & Tools
Pre-Bill	Real-time eligibility check, automated prior authorization, demographic validation
Coding	Autosuggestion of ICD-10/CPT codes using AI coding engine
Charge Entry	OCR-enabled capture from lab LIS or requisition forms
Claim Scrubbing & Submission	Multi-payer rules engine + AI-based scrubber
Denial Management	Auto-classification, predicted resolution routing, appeal letter generation
Payment Posting	Robotic EOB parsing and auto-posting with exception handling
Patient Billing	Smart statement scheduling, SMS/email reminders, digital wallet integration
Analytics	Predictive AR forecasting, payer behavior insights, audit trails

Advanced Features Driving Results

Denial Prediction Engine

Uses payer history, claim attributes, and documentation gaps to flag high-risk claims before submission
Suggests corrective actions to improve first-pass yield

Out-of-Network Optimization

Fee schedule modeling, UCR analysis, and negotiation automation tools to capture maximum reimbursement
Management of Pay-to-Patient flows, appeal cycles, and balance recovery with minimal manual intervention

Patient Responsibility Maximization

Digital patient portal with 24/7 access to balances, statements, and payment options
Predictive scoring for the likelihood of payment, and auto-offer of payment plans based on profile
Integrated texting/email/SMS automation for reminders and education

Built-in Compliance & Audit Control

Full HIPAA, OIG, CMS, CLIA, and commercial payer compliance frameworks
Auto-updated rules library with payer-specific edits and documentation requirements
Secure, traceable logos of all billing actions for audit readiness and dispute resolution

Ready to Revolutionize Your Lab’s Billing?

Let us show you how automation, intelligence, and experience combine to maximize revenue, reduce costs, and give you complete control.