TAG:
clinical laboratories
TriCore Forges Ahead to Help Payers Manage Population Health
CEO SUMMARY: To develop new sources of revenue to offset declining fee-for-service payments, TriCore Reference Labs is collaborating with health insurers in novel ways to improve patient outcomes and lower healthcare costs. To achieve this, TriCore brings together data from lab tests, EHR…
May 20, 2019 Intelligence: Late Breaking Lab News
Canada faces a similar shortage of medical technologists (MTs) as exists in the United States. “We have reached the point now where some laboratories have been closed for weeks due to insufficient staffing, which is a cascading problem for patients and the healthcare system,” stated Maria Klement…
“I’m from the Government, and I’m here to help.”
Across the nation, clinical laboratories struggle to correctly interpret and follow the new National Correct Coding Initiative (NCCI) guidelines that took effect on Jan. 1. A financial disaster lies ahead for many labs. “The denials are very high right now and those denials are nationwide,” stat…
New UnitedHealthCare Preferred Lab Network Launches July 1
This is an excerpt from a 1,900-word article in the April 29, 2019 issue of THE DARK REPORT. The full article is available to members of The Dark Intelligence Group. CEO SUMMARY: A new UnitedHealthCare (UHC) preferred lab network will launch July 1 with seven lab companies. In an April…
ACLA: NCCI Guidelines Are a ‘Step Backwards’
CEO SUMMARY: In a letter to the National Correct Coding Initiative, the American Clinical Laboratory Association (ACLA) raised significant concerns about new language in the policy manuals for Medicare and Medicaid. ACLA said the new NCCI guidelines for molecular and other tests requiring…
UHC Sets July 1 Launch for New Preferred Network
CEO SUMMARY: UnitedHealthcare will launch a new preferred laboratory network with seven lab companies on July 1. In an April 22 announcement, UHC said physicians and consumers may continue to use its existing network of more than 300 labs currently in-network. One goal is to give patients…
Labs Get High Denial Rates Under New NCCI Rules
CEO SUMMARY: Under guidelines the National Correct Coding Initiative issued last year, many clinical laboratories are not getting paid for some tests. The rates of denial for labs running mostly molecular tests could range from 40% to 100% of revenue, one billing expert said. Implemented …
Nine Lab Groups Say New NCCI Policy Is Inconsistent
CEO SUMMARY: By its name alone, the National Correct Coding Initiative (NCCI) Policy Manual implies that it will be accurate and consistent with other coding initiatives. But nine groups representing various clinical laboratories say NCCI guidelines that the federal Centers for Medicare a…
AP Groups Can Protect Revenue, Pathologist Compensation
CEO SUMMARY: Many anatomic pathology groups are watching their revenue decline and margins shrink on the same or greater case volume. These trends make it imperative to have a deeper understanding of the operational and financial variables that contribute to stability in the group’s fi…
Is Your Lab Prepared for More Tough Challenges?
THERE IS A NEW FAVORITE WORD WALL STREET ANALYST USE when they want to describe an industry that is going to experience tough times that will make it difficult for companies to grow and remain profitable. That word is “headwinds” and it can aptly be applied to the multiple tough challenges that a…
CURRENT ISSUE
Volume XXXII, No. 6 – April 21, 2025
Now that a federal judge has vacated the FDA’s LDT rule, The Dark Report analyzes the judgement and notes the various steps the FDA could take in response. Also, lab testing at pharmacies is proving to be less successful than was once anticipated.
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