CEO SUMMARY: Deep cuts in what Anthem pays pathologists for the professional component for certain AP services are having a harmful effect on the long-standing relationships that dermatologists have with dermatopathologists, some physicians say. By disrupting these relationships, Anthem is harming patient care, they add. Since late last year, in a growing number of states,
Tag: Anatomic pathologySkip to articles
Anatomic pathology is about diagnosing disease through the examination of organs and tissue samples by using a microscope, or through molecular, biochemical or immunological means.
It differs from clinical pathology, where diseases are diagnosed through analyzing bodily fluids in a lab.
In anatomic pathology, a physician trained in pathology examines surgical specimens (e.g., from a biopsy). This contrasts from clinical pathology, where blood, throat cultures, and urine as sent to a lab for analysis to determine whether a patient either has or is at risk for several biological diseases.
The American Board of Pathology is one of the primary certification organizations for anatomic pathologists. To be certified in anatomic pathology, a physician must complete four years of medical school and three years of residency. To be certified in both anatomic and clinical pathology, a physician must do four years of residency.
Anatomic pathologists typically work in hospitals, and pathology in general is most times practiced in hospitals and academic medical centers, where research is being conducted.
This is an excerpt of a 2,576-word article in the July 22, 2019 issue of THE DARK REPORT (TDR). The full articles are available to members of The Dark Intelligence Group.
CEO SUMMARY: Within five years, members of the millennial generation will make up 75% of the physician workforce in the United States,according to a recently
CEO SUMMARY: Within five years, members of the millennial generation will make up 75% of the physician workforce in the United States, rising from about 24% in 2017. That three-fold increase represents a strong demographic trend that will require changes in the steps all clinical laboratories and pathology groups take when seeking to attract and
CEO SUMMARY: Reviewing an AP practice’s expenses is vitally important today when payers are cutting reimbursement. In the past, government and private payers paid more for the technical and professional components of anatomic pathology work, but those rates have eroded. While conversations about revenue tend to obscure the need to talk about expenses, effective financial
CEO SUMMARY: As of Aug. 1, Aetna will stop paying out-of-network pathologists for the professional component review of certain clinical pathology tests. Until now, the health insurer has paid for the professional component when out-of-network labs billed for clinical lab tests using the modifier 26. In a notice to labs, Aetna said it will pay
CEO SUMMARY: Anthem is making big changes to its relationships with anatomic pathology groups. Getting most of the attention at the moment are the insurer’s letters announcing price cuts for anatomic pathology services of 50% to 70% of Medicare fees. But another major change may also trigger negative consequences for pathologists. Anthem is moving pathology
This is a synopsis of a 2,120-word article in the July 1, 2019 issue of THE DARK REPORT (TDR). The full articles are available to members of The Dark Intelligence Group.
CEO SUMMARY: Anthem is making big changes to its relationships with anatomic pathology (AP) groups. Getting most of the attention at the moment are the
TWO OF THE NATION’S LARGER HEALTH INSURERS—AETNA AND ANTHEM— ARE CUTTING WHAT THEY PAY for the professional component of certain clinical and anatomic pathology codes.
In its communications with pathology groups about this policy change, Aetna says it will no longer pay for most clinical laboratory claims submitted with the modifier 26 for professional component services.
CEO SUMMARY: Pathologists seeking jobs will find that a more competitive job market is pushing salaries up over $300,000 per year on average. In addition, most new jobs come with a hiring bonus and funds for relocation of as much as $12,000 and for continuing medical education of $3,500. But these higher salaries also come
TWO ANATOMIC PATHOLOGY SUPERGROUPS in two different regions joined forces this month. This happened when PathGroup of Nashville, acquired Pathologists Bio-Medical Laboratories (PBM) of Dallas.
Both groups are similar in that they are very large and do a combination of anatomic, clinical, and molecular testing. PathGroup has 75 physicians and PhDs on its staff and PBM