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How Labs, Pathologists Should Prepare for Payer Audits
PAYER AUDITS ARE ON THE RISE, AND CLINICAL LABORATORIES AND PATHOLOGY PRACTICES THAT ARE NOT ADEQUATELY PREPARED could face millions of dollars in unexpected recoupment demands. That’s the word from Jane Pine Wood, JD, a healthcare attorney with McDonald Hop…
OPKO Settles Allegations of Fraudulent Billing
DEMONSTRATING THAT EVEN ROUTINE TESTS CAN CAUSE LEGAL HEADACHES for clinical laboratories, the U.S….
Role of Price Transparency During Path Contract Talks
CEO SUMMARY: Pathology groups have a much better opportunity to turn the tables on payers and other third parties during contract negotiations if they come armed with the data and other information recommended by two well-respected pathology experts…
Grim Realities Drive Payer Behavior with Lab Test Claims
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Pathology Compensation in Different Settings, including Hospitals
CEO SUMMARY: This second installment on the series about boosting pathologist compensation uses data collected during a survey of 1,400 pathologists in 230 pathology practices by the Panel of National Pathology Leaders (PNPL). Two experienced pathology consultants identify the most effect…
Lawsuits Challenge Business Practices of Health Plans
IT MAY BE THAT SEVERAL RECENT FEDERAL LAWS AND RULES ON TRANSPARENCY IN HEALTHCARE are allowing aggrieved parties to pull back the curtain on unsavory practices at certain health insurance companies. Both self-insured employers and the employees of these companies are filing lawsuits claiming that pa…
Proven Ways to Improve Pathologist Productivity and Compensation
CEO SUMMARY: There is now extensive data from 1,400 pathologists serving in 230 pathology groups that show certain clinical and business strategies can lift a group’s collected revenue and increase the total annual compensation of the group’s pathologists. This is the first of a serie…
Significant Developments Are Shaping Lab Market
CEO SUMMARY: With 140 speakers and 1,000+ attendees, this year’s Executive War College again provided a comprehensive picture of the specific forces reshaping the U.S. market for lab testing services. Presented here is a smorgasbord of information and innovation shared by different spea…
Payer Contracts with Labs: Getting the Contract Is Just the Start
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Year’s Top 10 Lab Stories Contain Surprises & Twists
CEO SUMMARY: With the SARS-CoV-2 pandemic now in the rearview mirror of the nation’s clinical labs and pathology groups, the important news stories of 2023 were mostly about developments where the consequences will influence laboratory operations in coming years. Artificial intelligence…
CURRENT ISSUE
Volume XXXII, No. 7 – May 12, 2025
Economic, Tech changes drive lab concerns, The Dark Report provides insights from the Executive War College speakers about how clinical labs can use business strategies and tactics to handle the new tariffs, future regulations, and artificial intelligence (AI). Also, this issue provides guidance on how labs and pathologists should prepare for payer audits.
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