TAG:
managed care
Payers Are Right to Be Wary of Claims for Some LDTs’ Value
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How Private Payers Audit Labs for Possible Claims Fraud
EDITOR’S NOT…
‘Virchow’ Is Your New Source of Managed Care Insights
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?
EDITOR’S NOT…
Payers Continue to Increase Coverage of Liquid Biopsies
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’
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
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
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 …
2019’s Top 10 Lab Stories Reveal Major Laboratory Industry Trends
This is an excerpt of a 3,163-word article in the Dec. 16, 2019 issue of THE DARK REPORT (TDR). The full article is available to members of The Dark Intelligence Group. CEO SUMMARY: There was plenty of bad news in 2019 for clinical labs and pathology groups. Yet lurking inside this new…
How Labs Can Add Value for Providers, Insurers, Pharma
CEO SUMMARY: For pathologists and clinical, molecular, and genetic testing labs, appropriate reuses of lab data can provide a new source of revenue. Labs that serve as preferred providers of diagnostic testing data can help health systems, ordering physicians, pharmaceutical companies, an…
CURRENT ISSUE
Volume XXXI, No. 12 – September 3, 2024
This special intelligence briefing—presented in three parts—identifies the factors retarding a faster adoption of digital pathology. Also, how to protect your lab’s proprietary LDTs and assess the financial impact of compliance.
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