Patient Delays and Frustration from Verification Holds

$10,000–$40,000/month in delayed or lost Medicare/Medicaid test revenue, write-offs from non-billable services, and reputational damage with providers who see repeated government program issues and redirect patients. • $10,000–$40,000/month in lost DTC orders and reduced conversion rates on the lab’s portal, plus brand damage as dissatisfied patients leave negative reviews and do not return. • $10,000–$50,000/month in lost test revenue from abandoned visits and patient churn, plus $3–$4 in excess admin cost per manually verified or reworked claim and additional write-offs from eligibility-related denials.

Admin manually exports to Excel for batch payer calls • Billing manager directs staff to phone verification • Client services staff bounce between payer portals, LIS, and EMR, make phone calls to payers, use printed cheat-sheets of coverage policies, and track unresolved eligibility issues in personal spreadsheets, sticky notes, or email threads until they get an answer.