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revenue cycle management
Test price data shows major difference between Medicare lab fee schedule and private payers
By Mary Van Doren | From the Volume XXIII No. 15 – November 7, 2016 Issue
This is an excerpt from a 1,500-word article in the November 7 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 DA…
XIFIN Analysis of Its Real Price Data Shows Hospital Lab Price Effect
By Joseph Burns | From the Volume XXIII No. 15 – November 7, 2016 Issue
CEO SUMMARY: In a new analysis of data its lab clients will use to report market prices to CMS, XIFIN Inc., reports private payers paid independent labs a weighted average price that was 19.6% less than what Medicare pays for 20 of its highest-volume tests. By contrast, private payers pa…
Anatomic Pathology Profession Faces Challenges, Opportunities
By Joseph Burns | From the Volume XXIII No. 11 – August 15, 2016 Issue
CEO SUMMARY: For 10 years, three primary trends have reshaped the anatomic pathology profession. They are declining reimbursement, competition from physicians establishing in-office pathology labs, and a host of new government laws and regulations. More changes are coming, predicts one bu…
Payers Asking for Repayment When Labs Waive Fees
By Joseph Burns | From the Volume XXIII No. 7 – May 23, 2016 Issue
CEO SUMMARY: Health insurers appear to have stepped up their efforts to warn clinical laboratories not to waive patients’ fees in return for specimen referrals. Consultants also say that payers are increasing enforcement efforts. There are cases where, when insurers discover labs have n…
How to Cover Genetic Tests Confounds Health Insurers
By Joseph Burns | From the Volume XXIII No. 5 – April 11, 2016 Issue
CEO SUMMARY: Managed care experts say health insurers are being overwhelmed by the number of new genetic tests and that many labs find it tough to get paid for these tests. UnitedHealthcare just announced it will require pre-authorization of molecular and genetic tests during 2016. Me…
Form 5010 Update: Medicare Extends 5010 Implementation For a Second Time, Effective July 1, 2012 – The Dark Report April 21, 2012
By R. Lewis Dark | From the Volume XIX No. 6 – April 23, 2012 Issue
CEO SUMMARY: FACED WITH THE FACT that many payers were not ready to implement the 5010 standard under the …
New Company Ready to Heat Up Slow Digital Pathology Market
By Robert Michel | From the Volume XXII No. 11 – August 3, 2015 Issue
CEO SUMMARY: There’s a new competitor in the digital pathology marketplace with ambitious plans to deliver a fully-integrated pathologist workflow solution. Inspirata, Inc., of Tampa, Florida, made its debut in March at an international pathology conference. In this exclusive i…
October 13, 2014 “Intelligence: Late-Breaking Lab News”
By Robert Michel | From the Volume XXI No. 14 – October 13, 2014 Issue
Quality management systems (QMS) have made inroads in some of the organizations that accredit clinical laboratories in the United States to the requirements of CLIA. Last month, COLA of Columbia, Maryland, acknowledged that it had recertified to the standards of ISO 9001: 2008. The r…
NorDx CEO Shares Five Rules Critical to every Lab’s Success
By Joseph Burns | From the Volume XXI No. 11 – August 11, 2014 Issue
CEO SUMMARY: To meet the financial challenges of healthcare today, clinical labs and pathology groups can follow the five classic lab rules of success. However, as noted by Stan Schofield, CEO of NorDx Laboratories in Scarborough, Maine, the “old school” methods need …
Newsmaker Interview: Adam Slone, Tara Kochis
By Joseph Burns | From the Volume XX No. 13 – September 30, 2013 Issue
“When it comes to hiring senior leaders, labs today are more diligent in recruiting and interviewing candidates for key executive and management positions. One reason for this change is the shrinking financial margins at most labs.” …
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Volume XXXI, No. 6 – April 29, 2024
Laboratory managers will want to note that The Dark Report itself was targeted by the fraudsters who hit Change Health in a cyberattack. Also, one lab has some innovative methods of combatting the chronic staffing shortage, including hiring college graduates and students.
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