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Negotiating Path Contracts with Hospitals, Third Parties
By Robert Michel | From the Volume XXXII, No. 2 – January 27, 2025 Issue
PART THREE OF A SERIES TO HELP ANATOMIC PATHOLOGY GROUPS THRIVE AND PROSPER during these challenging times, The Dark Report presents this third installment in a series that identifies clinical, operational, and financial strategies pathology groups…
Managing Denials and Appeals of Clinical Lab, Path Claims
By Robert Michel | From the Volume XXXI No. 15 – November 4, 2024 Issue
CEO SUMMARY: Based on a study of denials and appeals involving about 20 million lab test claims, the team at XiFin Inc. presents here their findings. They also provide recommendations on steps labs can take to reduce denials and win a greater proportion of appeals. IN RECENT…
Hurdles Continue When Labs Request Genetic Test Coverage
By Virchow | From the Volume XXXI, No. 13 – September 23, 2024 Issue
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Behind-the-Scenes Audits Often Hide Cause of Test Claim Denials
By Virchow | From the Volume XXXI, No. 9 – July 1, 2024 Issue
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Walgreens to Close 60 VillageMD Locations
By Robert Michel | From the Volume XXXI, No. 5 – April 8, 2024 Issue
CEO SUMMARY: Following substantial losses in fiscal 2023, Walgreens is working to cut costs and reduce overhead. One casualty in this effort will be the closure of 60 of the 360 primary care clinics in retail pharmacy stores built by Walgreens in recent years. These actions demonstrate th…
Layoffs at Major Health Plans Slow Processing of Lab Claims
By Virchow | From the Volume XXXI, Number 1 – January 16, 2024 Issue
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Payers Request More Claims Documentation
By Robert Michel | From the Volume XXX, No. 7 – May 8, 2023 Issue
CEO SUMMARY: Both anecdotal evidence from lab professionals and numbers-based data from XiFin point to a problem: More payers require clinical labs to produce more documentation that a test claim i…
Coverage, Reimbursement Still Difficult for New Lab Tests
By Robert Michel | From the Volume XXIX, No. 11 – August 8, 2022 Issue
CEO SUMMARY: Bringing a new proprietary diagnostic test to market is an arduous process. It takes patience and planning to complete the journey from test development to payer reimbursement. This slow process stems from the fact that the healthcare reimbursement system is fragmented,…
June 6, 2022 Intelligence: Late-Breaking Lab News
By Robert Michel | From the Volume XXIX, No. 8 – June 6, 2022 Issue
Monkeypox is the latest disease showing up in the United States. That means hospital laboratories will want to be ready to diagnose monkeypox cases that show up in their emergency departments. An official from the Centers for Disease Control and Prevention (CDC) says it is exploring the possib…
Insurers Get Aggressive with Years-Old Audits, Searching for Lab Overpayments
By Robert Michel | From the Volume XXVIII, No. 11 – August 16, 2021 Issue
This is an excerpt of a 1,971-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: Not only are health insurers looking back to find lab overpayments and funds paid erroneously, but…
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