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Volume XXXII, No. 11 - August 4, 2025

Clinical Labs Battle Complex Claims Denials

Laboratory Billing /

CEO SUMMARY: While the number of denials is not going up, the reasons that private payers deny claims are becoming more complex and time-consuming to appeal. After reviewing noteworthy trends among payers, learn a three-level approach to appeals that may lead to greater success and speed up the process. AS PAYERS ADOPT NEW STRATEGIES IN […]

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Clinical Laboratories Battle Complex Claims Denials

TDR Insider /

While the number of denials is not going up, the reasons that private payers deny claims are becoming more complex and time-consuming to appeal. After reviewing noteworthy trends among payers, learn a three-level approach to appeals that may lead to greater success and speed up the process. “The good news is that the volume of

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Don’t Let the Payers Enjoy All the Benefits of Data

Commentary and Opinion by R. Lewis Dark /

PROBABLY SINCE THE ADVENT OF MANAGED CARE, CLAIMS REIMBURSEMENT at its core has been about data. And lots of it. True, it was reams of paper about claims at one point, and now it’s largely digital submissions. The format is irrelevant; those claims contain useful strategic information for both payers and clinical laboratories. Of course,

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AI Hype in Labs: 6 Tips to Sniff Out the BS

Clinical Laboratory Trends /

CEO SUMMARY: In the final entry of our artificial intelligence series, the co-founders of Sample Healthcare discuss how clinical labs can evaluate AI vendors effectively, with an emphasis on assessing technical credentials and quick proofs of concept. Armed with the right information, labs can perform a successful AI evaluation that explores phased rollout and end-to-end

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2025 Trends in Pathology Resident Match Programs

Pathology Trends /

EACH YEAR, THE NATIONAL RESIDENCY MATCHING PROGRAM (NRMP) tracks and analyzes The  Match, a system established for matching the preference of medical students applying for residency positions in the United States. An analysis of the NRMP report’s data about anatomic pathology residents shows a steady percentage of pathology residents, out of the overall population of

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At ADLM 2025, Spotlight Shines on Relationships

Clinical Laboratory Trends /

CEO SUMMARY: At the ADLM conference, a new industry survey about the dynamic relationship between medical laboratories, physicians, and patients presented a strong argument for labs taking the lead in communicating and being more accessible to their colleagues. A troublesome number of physicians report that they do not rely on lab expertise to guide testing

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JAMA Authors Warn LDT Legal Defeat Brings Risk for Labs

Laboratory Compliance /

CLINICAL LABORATORY AND ANATOMIC PATHOLOGY LEADERS WILL WANT TO NOTE will a recent JAMA Health Forum article that strikes a cautionary tone about the future of laboratory developed test (LDT) regulation. The piece argued that the recent federal court decision striking down the Food and Drug Administration’s (FDA) LDT final rule could have unintended consequences

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Fast, $17.5B Deal Lands Waters Corp. in IVD Market

In Vitro Diagnostics /

WHEN BECTON DICKINSON  (BD) ANNOUNCED ITS INTENT to spin off its in vitro diagnostics (IVD) and life sciences units in February, few observers expected a deal to close just five months later. But now that such an agreement has occurred as of July 14, the buyer—Waters Corporation—finds itself dropped into a competitive industry that is

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August 4, 2025, Intelligence: Late-Breaking Lab News

Late Breaking Lab News /

In a filing with the US Securities and Exchange Commission, UnitedHealth Group (UHG) has acknowledged it is under investigation by the US Department of Justice (DOJ). “[UHG] proactively reached out to the Department of Justice after reviewing media reports about investigations into certain aspects of the company’s participation in the Medicare program,” the July 23

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