TAG:
lab billing
CMS Adjustments for Medicare Fee Schedule Might Be Too Late
This is a summary of two articles in the Nov. 13, 2018 issue of THE DARK REPORT. The complete articles are available only to paid members of the Dark Intelligence Group. CEO SUMMARY: On Nov. 2, the federal Centers for Medicare and Medicaid Services released its Physician Fee S…
NILA, ACLA Respond to CMS 2019 Final Lab Rule
CEO SUMMARY: On Nov. 2, the federal Centers for Medicare and Medicaid Services released its Physician Fee Schedule for 2019. It says it will expand the number of labs from which it collects data about the lab test prices paid by private health insurers. While some labs may welcome these c…
Attorney Explains 70/30 Rule, Pass-Through Bill Arrangements
HOW THE LAB OUTREACH BUSINESSES of rural hospitals originate lab specimens and bill for lab tests is getting increased scrutiny. The reason for this rise in interest is that a growing number of rural hospitals are generating almost as much revenue from laboratory outreach testing as they get from all…
Lab companies and bankrupt hospitals: Dancing around medical billing fraud
This is an excerpt from a 2,000-word article in the May 29, 2018 issue of THE DARK REPORT. The complete article is to all readers as long as the article limit has not been reached, and always available to paid members of the Dark Intelligence Group. …
Why Lab Companies Buy Bankrupt Rural Hospitals
CEO SUMMARY: Seeking the higher lab-test payment rates that insurers pay hospital labs, some lab testing companies are buying rural, financially-struggling hospitals in what may be the latest twist on the pass-through billing strategy that certain lab testing firms have found to be lucrat…
Strategies to Offset Medicare Cuts to Be Shared at Exec. War College
DEEP PRICE CUTS to the Medicare Part B Clinical Laboratory Fee Schedule was the big story of 2017. The big story of 2018 may be the widespread financial disruption to the clinical lab industry as labs see dramatic declines in their revenue from these Medicare fee cuts. One early opportunity for lab …
Aetna Sues Hospitals over Alleged Lab-Billing Scheme
CEO SUMMARY: In September, Aetna filed a lawsuit in Pennsylvania accusing 14 defendants—including a hospital, a hospital management company, eight lab companies or lab management companies, two physicians, and two individuals—of defrauding Aetna, its client employers, and its members….
Expert Explains Why Payer Errors Skew Labs’ PAMA Price Data
CEO SUMMARY: In its work with more than 200 lab clients, XIFIN, Inc., of San Diego, sees the best and worst of problems in how labs submit claims to lab tests and how payers process these claims. In this exclusive interview, Lâle White, XIFIN’s Founder and CEO, identifies the systemic …
Price Cuts, Long Delays in Payment Are Expected – December 31, 2012
CEO SUMMARY: In addition to a steep cut in the 88305 CPT code, anatomic pathology laboratories can expect cuts in the payment from Medicare for molecular and prostate biopsy testing. Two national experts in lab billing and reimbursement warn labs to expect confusion in how both pub…
NorDx CEO Shares Five Rules Critical to every Lab’s Success
CEO SUMMARY: To meet the financial challenges of healthcare today, clinical labs and pathology groups can follow the five classic lab rules of success. However, as noted by Stan Schofield, CEO of NorDx Laboratories in Scarborough, Maine, the “old school” methods need …
CURRENT ISSUE
Volume XXXI, No. 13 – September 23, 2024
The Dark Report has visited several companies in Europe to see what innovations they have developed that might be coming to laboratories and pathology groups in the U.S. Also, hospital lab outreach businesses are still valuable commodities in the eyes of the Blood Brothers. In addition, The Dark Report delivers the 2nd quarter earnings reports of the top global IVD companies.
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