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electronic health record systems

LIS-EHR Fees Increasing, Say Hospital Lab Execs

CEO SUMMARY: Hospital and health system lab managers say some vendors of electronic health record systems for independent physicians are aggressively raising the fees they charge labs. Labs serving outreach physicians now pay more in two ways, they say. First, they pay the price the vendo…

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Lower Prices, More Data in UHC’s New Lab Network?

CEO SUMMARY: It’s been a common strategy among managed care payers to seek the lowest prices for clinical laboratory testing when negotiating contracts with labs. However, lower prices may become less important over time as the health system moves away from fee-for-service payment towar…

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Issues Encountered with Anthem’s Pre-approval

CEO SUMMARY: Since Anthem and AIM Specialty Health began a prior-authorization program for genetic testing July 1, a Northeast lab has not had any genetic tests approved through the new system. Physicians told the lab that the steps required for prior authorization were disruptive. Those …

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In Texas, BeaconLBS Start Will Be Delayed

CEO SUMMARY: UnitedHealthcare will not implement the claims impact part of its laboratory benefit management program in Texas on March 1, 2017, as it had previously announced. Opposition to the program and the requirement that physicians use the BeaconLBS system when ordering about 79 lab…

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In Texas, Questions for UnitedHealth, BeaconLBS

CEO SUMMARY: As of January 1, 2017, clinical laboratories and pathology groups in Texas will find it more difficult to serve the 500,000 patients enrolled in UnitedHealthcare’s fully-insured commercial plans in the Lone Star State. That’s because—just as it did in Florida—UnitedHe…

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Pathologists Contribute To Care in Wisconsin ACO

CEO SUMMARY: From the launch in 2013 of a big accountable care organization in Wisconsin, the North Shore Pathologists at Columbia-St. Mary’s Hospital have been involved. Among the lessons learned are the importance of structuring the pathology contract with the hospital to antic…

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Florida Doc Says Questions Go Unanswered by UHC

CEO SUMMARY: One common complaint about the efforts of UnitedHealthcare to introduce its unpopular laboratory benefit management program in Florida is that the insurer-and its agent, BeaconLBS, a division of Laboratory Corporation of America-don’t respond to physicians when they …

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UnitedHealth Sets April 15 to Start Claims Impact of Lab Program

APRIL 15 IS THE DATE when UnitedHealthcare will begin denying laboratory claims in Florida that do not meet the requirements of its unpopular laboratory benefit management program. The health insurer sent out notices last month to alert physicians and laboratories that it will implement what it call…

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Rheumatologists Oppose UnitedHealth’s BeaconLBS

CEO SUMMARY: Yet another specialty society is opposing the laboratory benefit management program UnitedHealthcare introduced in Florida last fall. Rheumatologists have joined four other specialty physicians in saying UHC’s BeaconLBS system could be detrimental to patient care. In…

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July 29, 2013 “Intelligence: Late Breaking Lab News”

Another national health insurance corporation is preparing to institute pre-authorization for genetic tests. Cigna Corporation announced on July 23 that it had selected InformedDNA, to administer its new genetic testing and counseling program. Pathologists and laboratory administrators …

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