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July 2021

Genetic Testing Continues to Grow in Volume and Complexity

This is an excerpt of a 1,333-word article in the July 26, 2021 issue of  THE DARK REPORT (TDR). The full article is available to members of The Dark Intelligence Group. CEO SUMMARY: Getting paid for genetic testing continues to be a challenge. This is true for both payers and the labs that perform the […]

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Goodbye Clinical Labs! Hello Genetic Testing Labs!

IS THE CLASSIC MODEL OF THE INDEPENDENT PATHOLOGIST-OWNED CLINICAL LABORATORY that is the sole source provider of all routine, reference, and esoteric testing to physicians in its community on its way to extinction? There is strong evidence to support a “yes” answer to that question.  The heyday of the local, pathologist-owned independent lab company was

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Artificial Intelligence Is Ready to Deliver for Labs

CEO SUMMARY: Artificial intelligence (AI) may be one of the most over-used terms to describe a host of different applications, software tools, and products. However, during the past year, some truly revolutionary digital tools are now in use by a small number of innovative clinical laboratories. These applications are being used to improve operational work

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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 problem is likely to get worse before

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CLIA Accreditation Market: More Competitive Now?

CEO SUMMARY: It’s been three decades since compliance with the Clinical Laboratory Improvement Amendments (CLIA) became mandatory. During that time, there has been little competition among the major organizations with deeming status by the Medicare Program to accredit labs to CLIA. However, decisions by several major health systems to change the CLIA-accreditation provider they had

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How to Achieve Success with Genetic Test Prior Authorization

AS MANAGED CARE PAYERS INCREASINGLY REQUIRE PRIOR AUTHORIZATION FOC GENETIC TESTS, clinical laboratories should understand the ins and outs of what it takes to get reimbursed for testing they provide.  Almost all payers now require prior authorization (PA) for genetic testing, said Heather Agostinelli, Vice President, strategic revenue operations, with XIFIN Inc., a revenue cycle

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PacBio Beefs Up with Purchase of Omniome for $800 Million

FORWARD-LOOKING PATHOLOGISTS AND LAB ADMINISTRATORS understand that the next big game in medical laboratory testing will be assays built upon genome sequencing. They also know that several companies are racing to produce gene sequencing instruments that are faster, simpler, and less costly in order to serve the needs of clinical labs.  Currently, Illumina, Inc., of

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July 26, 2021 Intelligence: Late-Breaking Lab News

Intermountain Healthcare of Salt Lake City announced that it plans to close 25 of its 26 retail pharmacies as early as next month. It cited declining business and a new business arrangement with CVS Health, the national pharmacy chain. Daron Crowley, Intermountain’s media relations director, told the Salt Lake City Tribune that “they aren’t being

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Interesting New Surprises for Lab Leaders

Unexpected and surprising things continue to happen in the clinical laboratory industry. You might consider that to be one unifying theme to the intelligence briefings we present in this issue of The Dark Report.  For example, a pathology lab company in New Jersey sued UnitedHealthcare (UHC) seeking payment for 46,400 molecular COVID- 19 test claims

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Genesis Lab Lawsuit Pursues UnitedHealth Over Unpaid Test Claims

This is an excerpt of a 1,946-word article in the July 6, 2021 issue of  THE DARK REPORT (TDR). The full article is available to members of The Dark Intelligence Group. CEO SUMMARY: New case law in how health insurers should reimburse for COVID-19 lab test claims might be one outcome of Genesis lab’s lawsuit

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