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IHC Reimbursement Is Changing.
What Pathology Groups Need to Know Now.

Download Lighthouse’s whitepaper to understand how payer policy changes, documentation requirements, frequency limits, and prior authorization risk may affect pathology reimbursement.

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Why Pathology Groups Should Pay Attention

Across the payer landscape, pathology providers are facing expanded coverage limitations related to immunohistochemical and special histochemical stains. These changes can create reimbursement risk even when staining is clinically appropriate. Lighthouse is seeing increased scrutiny around:

• Frequency limits for multiple IHC stains on a single specimen
• Narrower interpretations of medical necessity
• Documentation requirements tied directly to payer coverage language
• Greater administrative burden and denial exposure

"Lighthouse has been a true ally through the years, battling the slings and arrows of the Pathology world. I can rely on them to keep up with laws and issues we face, while I focus on Pathology and patient care. They provide oversight over our billing office, which sometimes needs prodding. They have my back, and I appreciate the help."

Dr. Weiss

"When it comes to Pathology billing, Lighthouse Lab Services is the go-to expert. They will get your billing and reimbursement processes running like a well-oiled machine."

Robbie Graham, MD, Comanche County Memorial Hospital

"We partner with Lighthouse because they are always a step ahead. They have strengthened our practice with their knowledge and expertise. We appreciate their dedication and integrity!"

Lucent Pathology Partners

"Our group has used Lighthouse for many years. When we started they did an in depth investigation of our billing process and identified areas where we could make improvements and increase our monthly revenue. They took us through two different RFP processes for billing agencies and helped identify the best match for us. Through all of this they have been knowledgeable, professional, and efficient, displaying integrity by reducing their fee during our lowest months. I highly recommend them."

North Pathology Associates

"Our pathology group has been using Lighthouse's Practice Management for the past year and have been very happy with the service. For the first time I feel confident that our billing company is compliant and giving us the service we need. Lighthouse helped us renegotiate our contract with a substantial savings. They also assisted in switching to a more effective collection service. It is nice to know that help is one call or text away and that I can trust their advice."

Dr. Merle Madigan

"My 6-man pathology group has used Lighthouse for over 10 years. They originally helped us select a replacement billing service. Since then they have monitored the billing service, provided formal audits, and maintained close contact with us with regular conference calls where billing information is reviewed and a practice management plan is discussed. They have provided advice on contractual negotiations with insurance companies and have provided the perspective of being closely involved with other practices and having a national presence in the pathology business arena. I have found them to be responsive to our needs. The value added to my practice easily justifies the expense of their service."

St Vincent’s Pathology

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