Unrecovered Revenue from Laboratory Claim Denials

$10,000–$50,000+ per month in uncollected self-pay balances and write-offs for DTC tests that were performed but not fully paid. • $100,000–$300,000+ in monthly lost collectible Medicare/Medicaid lab revenue from denials that are never appealed or are worked too late, plus additional labor cost for manual tracking and repeated payer calls. • $100,000–$500,000+ per year per major practice in lost or at-risk revenue when dissatisfied practices shift test volume to competitors due to unresolved denial and appeal frustrations.

Client Services manually reconciles the provider’s complaint against billing system records and payer responses, logs issues in spreadsheets or CRM notes, and requests ad‑hoc resubmissions or write-offs through email. • Client Services reps manually track denied claims that customers complain about, using ad‑hoc spreadsheets and notes from payer calls to decide which denials to escalate for appeal or rebilling. • Credentialing Specialist maintains employer contact list in CRM, manual quarterly outreach calls, relies on receiving employer plan change communications