Revenue Cycle Management
Specialized laboratory revenue cycle.
Diagnostic revenue cycle is not general healthcare RCM. DMC works specifically around molecular, anatomic pathology, toxicology, and genomics economics — where claims fail for reasons generic billing operations rarely diagnose.
Context, not just claims
We understand the reimbursement and scientific context behind the claim — not only the billing transaction.
Assay-level specificity
Coding, documentation, and payer policy handled per assay rather than per generic service line.
Senior accountability
Escalations reviewed by people who have built reimbursement strategy, not only processed claims.
Capabilities
A complete revenue cycle stack.
- 01
Prior Authorization
Payer-specific PA and medical-necessity workflows, supported by automation where it reduces manual burden. - 02
Coding integrity
CPT, PLA, HCPCS, modifier, Z-code, and CCI logic tuned to the specific assays in your menu, with pre-submission claim scrubbing. - 03
Denials & appeals
Root-cause review and payer-by-payer appeal workflows built around diagnostic coverage policy language. - 04
Managed Care Contracting
Contract strategy, negotiation, and modeling with commercial payers, Medicare Advantage, and Medicaid managed care. - 05
Reconciliation & analytics
Payment posting, reconciliation, and net revenue per test, per payer, and per assay with variance review.
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