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lab management

Cigna Audits Tox Test Labs For Proof that Patients Paid

CEO SUMMARY: In an unusually strong move, health insurer Cigna is auditing laboratories, including some labs that do toxicology testing. In these audits, the health insurer seeks documentation that the testing is medically necessary and that the laboratories are collecting copaym…

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Collecting Big Patient Deductibles

THERE HAS BEEN EXPLOSIVE GROWTH IN THE NUMBER OF PATIENTS enrolled in high-deductible health plans. Currently, more than 20 million people have HDHPs. This is one reason why many labs are experiencing high levels of patient bad debt never before seen by the lab industry during the past three decades….

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UnitedHealth Not Paying Lab Claims of Some Docs

CEO SUMMARY: It continues to be tough going in Florida for UnitedHealthcare and its contractor, BeaconLBS. Efforts to implement the UHC laboratory benefit management program face stiff resistance from some physicians and a number of state medical associations. One primary care gr…

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In Florida, UnitedHealth Delays BeaconLBS Claims Decisions

LAST WEEK, ONE PART OF THE Beacon Laboratory Benefit Solutions pilot program in Florida was postponed. A UnitedHealthcare spokesperson provided additional information about this decision. “We have lifted the January 1 claims impact de…

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Defining a Path to Clinical Laboratory Best-in-Class via Benchmarks

CEO SUMMARY: With the American healthcare system undergoing a major transformation, it is essential that all clinical laboratories and pathology groups recognize this transformation and effect the right strategies to meet the needs of physicians, patients, and payers. A g…

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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 …

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Excluding Lab Competitors Helps Big Labs Grab Greater Market Share

CEO SUMMARY: Changes in healthcare are motivating health insurers and the nation’s largest lab testing companies to enter into contracts in which the large lab company lowers its lab test prices to the payer in return for having the payer exclude that lab company’s toughest competitor…

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Survival Essentials for Local Labs

IF THERE IS ANY SINGLE SIGN OF TOUGH TIMES FOR LOCAL LABS, it is decreasing access to patients due to the exclusionary contracting tactic of health insurers. That tactic is the …

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Bridging the Schism within your Laboratory

THERE’S A SIGNIFICANT SCHISM BECOMING VISIBLE within the house of laboratory medicine. I am calling your attention to this development because this schism probably exists within your own laboratory organization. On one side are a very large number of pathologists, lab administrators, and laborator…

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Speakers in New Orleans Offer Important Insights

CEO SUMMARY: In coming years, there will be multiple challenges and opportunities for the nation’s clinical laboratories and pathology groups. That was one common theme heard from the 90 speakers and panelists at the 19th annual Executive War College on Laboratory and Pathology Manageme…

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