Industries / Laboratories
Laboratories
High-volume, low-dollar, medical-necessity-ruled — lab billing where pennies decide margins.
Where the revenue leaks.
Missing diagnoses from referrers
Orders arrive without supporting dx codes; claims die on medical-necessity edits weeks later.
Low-dollar denials nobody chases
A $40 denial isn't worth a human's hour — so thousands of them are simply donated.
LCD/NCD rules shifting underfoot
Coverage policies change; yesterday's clean claim is today's denial pattern.
How GetMax runs it.
Necessity validated at intake
Orders checked against coverage policies up front; missing diagnoses chased from referrers before billing.
Automation that makes $40 worth it
When follow-up is automated, low-dollar denials become recoverable at scale.
Policy changes tracked
Coverage rule updates reflected in claim edits before denial patterns form.
Questions, answered.
Can you chase missing diagnosis information from referring providers?+
Yes — orders lacking supporting diagnoses are flagged at intake and pursued with referrers before claims go out, not after they bounce.
Is low-dollar A/R really worth working?+
Manually, rarely. Automated, yes — that's the entire economic argument for AI-native lab RCM.