TAG:
managed care
Don’t Let the Payers Enjoy All the Benefits of Data
By R. Lewis Dark | From the Volume XXXII, No. 11 – August 4, 2025 Issue
PROBABLY SINCE THE ADVENT OF M…
UnitedHealth Group Heads into Difficult Waters Mid-Year
By Scott Wallask | From the Volume XXXII, No. 8 – June 2, 2025 Issue
WITH THE NEWS THAT THE FORMER HEAD OF UNITEDHEALTH GROUP (UHG) has returned after the sudden resignation of the company’s CEO, it is apparent that pressure on the healthcare company continues to mount. This latest twist comes on top of a bad…
Payers Are Right to Be Wary of Claims for Some LDTs’ Value
By Virchow | From the Volume XXX, Number 17 – December 4, 2023 Issue
…
How Private Payers Audit Labs for Possible Claims Fraud
By Virchow | From the Volume XXX, No. 14 – October 2, 2023 Issue
EDITOR’S NOT…
‘Virchow’ Is Your New Source of Managed Care Insights
By R. Lewis Dark | From the Volume XXX, No. 11 – July 31, 2023 Issue
WE ARE UNVEILING A VALUABLE INTELLIGENCE RESOURCE FOR YOU. It is a new commentary focused exclusively on managed care contracting for diagnostic services provided by clinical laboratories and anatomic pathology gr…
With Z-codes, Will Other Payers Follow UnitedHealthcare’s Lead?
By Virchow | From the Volume XXX, No. 11 – July 31, 2023 Issue
EDITOR’S NOT…
Payers Continue to Increase Coverage of Liquid Biopsies
By Robert Michel | From the Volume XXVIII, No. 17 – December 20, 2021 Issue
SINCE THE FIRST BLOOD-BASED, circulating-tumor DNA (ctDNA) sequencing test for cancer became available in 2014, federal and private payer coverage of these so-called “liquid biopsy” tests has increased substantially. Now, clinical laboratory and pathology directors can expect additional coverage …
COVID-19 Lab Test Prices Give Some Health Plans ‘Indigestion’
By Robert Michel | From the Volume XXVIII, No. 11 – August 16, 2021 Issue
HEALTH INSURANCE PLANS CONTINUE TO BE UNHAPPY with the higher prices they are charged for COVID-19 tests by out-of-network clinical laboratories. That is one theme in a report on COVID-19 test prices published by a health insurance trade group. In its…
Benefits Investigation Is Growing Issue for Genetic Testing Labs
By Robert Michel | From the Volume XXVIII, No. 9 – July 6, 2021 Issue
QUIETLY AND WITH LITTLE NEWS COVERAGE, a new complication is challenging clinical laboratories that offer genetic testing. It involves a steady growth in the number of patients who do a “benefits investigation” before allowing their physician to order a genetic test….
Getting Payer Coverage for New Tests Continues to Be Difficult
By Robert Michel | From the Volume XXVIII, No. 8 – June 14, 2021 Issue
EVERY YEAR, IT BECOMES TOUGHER FOR CLINICAL LABORATORIES WITH NEW GENETIC AND OTHER TESTS to obtain favorable coverage decisions by government and private payers. Not only does it take longer to get a decision from a payer, but payers today want to see …
CURRENT ISSUE

Volume XXXII, No. 12 – August 25, 2025
In an exclusive interview, a laboratory industry M&A specialist discusses what’s driving lab outreach sales to national lab companies. Also, The Dark Report analyzes ways in which pathology and clinical labs can profitably partner with pharmaceutical companies.
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