There’s bad news for clinical labs and pathology groups that lack the capability of collecting copays, deductibles, and out-of-pocket payments from patients at time of service. As of October, 2016, four out of every 10 Americans under the age of 65 with health insurance had a high-deductible health plan. That means these patients are responsible
Tag: managed care
WITH HEALTHCARE POISED TO MAKE FUNDAMENTAL CHANGES in both the delivery of care (think integration, ACOs, medical homes) and how providers are paid (less fee-for-service, more budgeted payment methods), it is time for the entire profession of laboratory medicine to tackle the elephant in the room: lab tests bought and sold as commodities.
The commoditization of
ONE WAY THAT A CLINICAL LAB can fight back against insurers who refuse to pay lab test claims is to sue them. That’s exactly what Medical Diagnostic Laboratories of Hamilton, N.J. is doing!
Not only has MDL filed lawsuits against two major health insurance companies, but in one lawsuit, it named a national lab company as
CEO SUMMARY: Among the three chief reasons for the merger of CellNetix and Puget Sound Institute of Pathology, the most compelling was the need to address the challenges in the current reimbursement environment and to prepare for reductions in payment to pathologists expected in the coming years under the Patient Access to Medicare Act. CellNetix
BY NOW, NEARLY EVERY LAB MANAGER knows that Medicare lab test fee cuts will commence in just 13 months, on Jan. 1, 2018. The federal Centers for Medicare & Medicaid Services estimates that the final rule for PAMA private payer market price reporting will produce cuts of $5.4 billion over 10 years. (See TDRs, November
This is an excerpt from a 2,700-word article in the November 28 issue of THE DARK REPORT. The complete article is available for a limited time to all readers, and available at all times to paid members of the Dark Intelligence Group.
CEO SUMMARY: THE DARK REPORT delivers the most detailed explanation ever offered of the payer-to-lab
CEO SUMMARY: In its work with more than 200 lab clients, XIFIN, Inc., of San Diego, sees the best and worst of problems in how labs submit claims to lab tests and how payers process these claims. In this exclusive interview, Lâle White, XIFIN’s Founder and CEO, identifies the systemic sources of problems in the
CEO SUMMARY: Clinical labs must assess their responsibilities to report lab test market prices to CMS as part of the Protecting Access to Medicare Act. A panel of three experts took up this topic at a recent webinar hosted by THE DARK REPORT. On June 23, the federal Centers for Medicaid & Medicare Services published
CEO SUMMARY: Just eight weeks remain before certain clinical laboratories must begin submitting private payer lab test price data to the federal Centers for Medicare & Medicaid Services. A new report by the Office of the Inspector General makes it possible to estimate how CMS may implement fee cuts in 2018. THE DARK REPORT’s calculations show that a 10%
One of the most widely-respected and trusted attorneys serving the clinical laboratory industry and anatomic pathology profession is leaving private practice to join the corporate world.
Effective October 1, 2016, Jane Pine Wood becomes the new Chief Legal Counsel and Compliance Officer for Bio-Reference Laboratories, Inc., of Elmwood Park, New Jersey. Wood will leave McDonald Hopkins, based in