TAG:
current procedural terminology
Payers Are Right to Be Wary of Claims for Some LDTsâ Value
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Private Health Insurers Are Aware of Problems with CPT Code 81408
EDITORâS NO…
Technical Assessment Challenges for Z-Code Applications
CEO SUMMARY: Effective on Aug. 1, UnitedHealthcare will require Z-code submissions for many genetic tests. During a recent webinar, experts tackled a topic that may prove troublesome for labs seeking Z-codes: technical assessments. Key advice is to provide specific data about clin…
UnitedHealthcareâs Z-code Policy Starts on Aug. 1
CEO SUMMARY: UnitedHealthcareâs (UHC) response to the ever-growing number of unique genetic tests and the continuing growth in the volume of those claims is a new policy. Effective Aug. 1, UHC will require a Z-code with genetic test claims. This req…
Stressful Weeks Ahead for Labs Thanks to Z-codes
We are not alone in recognizing that UnitedHealthcareâs…
Coverage, Reimbursement Still Difficult for New Lab Tests
CEO SUMMARY: Bringing a new proprietary diagnostic test to market is an arduous process. It takes patience and planning to complete the journey from test development to payer reimbursement. This slow process stems from the fact that the healthcare reimbursement system is fragmented,…
Optum to Offer Laboratory Benefits Management to other Health Plans
This is an excerpt of a 1,355-word article in the June 21, 2022 issue of  THE DARK REPORT. The full article is available to members of The Dark Intelligence Group. CEO SUMMARY: UnitedHealth Group subsidiary Optum announced a new laboratory benefits management program aimed at impr…
UnitedHealthâs Optum to Offer Lab Test Management
CEO SUMMARY: UnitedHealth Group subsidiary Optum announced a new laboratory benefits management program aimed at improving utilization of genetic/molecular clinical laboratory testing. The goal is to save health plans money while bringing genetic test validity data prominently into …
Genetic Tests Grow in Number, Complexity
CEO SUMMARY: Getting paid for genetic tests continues to be a challenge. This is true for both payers and the labs that perform the tests. Even physicians are dissatisfied with the status quo because they must deal with patients unhappy about the high cost of genetic tests. The prob…
Lawsuits Allege LabCorp, Quest Overcharged Uninsured Patients
CEO SUMMARY: Court documents filed in U.S. District courts in New Jersey and North Carolina provide details about how each of the two lab companies set lab test prices differentlyâas much as 10 times higherâfor cash-paying patients than for patients who have Medicare, Medicaid, or com…
CURRENT ISSUE
Volume XXXI, No. 5 – April 8, 2024
The fragmentation of consumer markets is reflected in clinical lab services, and The Dark Report examines this trend and how it will impact labs in the coming years. Also, The Dark Report notes that the FDA has issued a controversial memo to reclassify many high-risk IVD assays.
See the full table of contentsHow Much Laboratory Business Intelligence Have You Missed?
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