CEO SUMMARY: Court documents filed in U.S. District courts in New Jersey and North Carolina provide details about how each of the two lab companies set lab test prices differently—as much as 10 times higher—for cash-paying patients than for patients who have Medicare, Medicaid, or commercial health insurance plans. In court filings, plaintiffs allege that
Tag: Medical laboratorySkip to articles
A medical laboratory or clinical laboratory is a laboratory where tests are done on clinical specimens in order to get information about the health of a patient as pertaining to the diagnosis, treatment, and prevention of disease.
Distribution of clinical laboratories in health institutions varies greatly from one place to another.
The staff of medical laboratories may include:
- Clinical biochemist
- Pathologist’s assistant (PA)
- Medical laboratory scientist (MT, MLS or CLS)
- Medical laboratory technician (MLT)
- Medical laboratory assistant (MLA)
- Phlebotomist (PBT)
In many countries, there are two main types of labs that process the majority of medical specimens. Hospital laboratories are attached to a hospital, and perform tests on patients. Private (or community) laboratories receive samples from general practitioners, insurance companies, clinical research sites and other health clinics for analysis.
These can also be called reference laboratories where more unusual and obscure tests are performed. These include Mayo Medical Laboratories, ARUP Laboratories, Quest Diagnostics and LabCorp. For extremely specialized tests, samples may go to a research laboratory. Many samples are sent between different labs for uncommon tests. It is more cost effective if a particular laboratory specializes in a rare test, receiving specimens (and money) from other labs, while sending away tests it cannot perform.
Laboratories today are held together by a system of software programs and computers that exchange data about patients, test requests, and test results known as a laboratory information system or LIS. The LIS is interfaced with the hospital information system.
This system enables hospitals and labs to order the correct test requests for each patient, keep track of individual patient or specimen histories, and help guarantee a better quality of results as well as printing hard copies of the results for patient charts and doctors to check.
Credibility of medical laboratories is paramount to the health and safety of the patients relying on the testing services provided by these labs. The international standard in use today for the accreditation of medical laboratories is ISO 15189. In the United States, under the Clinical Laboratory Improvement Amendments of 1988 (CLIA), accreditation of medical laboratories is done by the Joint Commission, College of American Pathologists, AAB (American Association of Bioanalysts), and other state and federal agencies. CLIA 88 or the Clinical Laboratory Improvement Amendments also dictate testing and personnel.
Pharmacogenetic testing is gaining acceptance by a growing number of health insurers. On Oct. 1, UnitedHealthcare (UHC) began coverage of genetic tests that help physicians identify the anti-depressant drugs most likely to benefit their patients. UHC’s policy also extends coverage to multi-gene testing for antipsychotic drugs. In writing about this decision, www.clinicalomics.com said, “UnitedHealthcare’s policy
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, and other organizations when they reuse lab test data to support evidence-based care and
IS IT A COINCIDENCE THAT, IN THIS ISSUE OF THE DARK REPORT, we cover two related developments, both involving the federal government’s efforts to control healthcare fraud and abuse?
First, you’ll read about the new federal rule scheduled to take effect on Nov. 4. It gives federal healthcare investigators new powers to exclude individuals and organizations
IT’S CALLED THE OPIOD CRISIS AND IT’S OFTEN A MAJOR STORY in the nightly news. In 2017, deaths from drug overdoses totaled 70,237, of which 68% (47,600) were opioid overdose deaths, according to the federal Centers for Disease Control and Prevention.
Across the nation, government health officials and healthcare providers struggle to address the problems of opioid
CEO SUMMARY: Today, insurers get risk-adjusted payments for treating patients who have high-cost health conditions and they make risk-adjusted payments to physicians, hospitals, and other providers. At Northwell Health, the clinical lab saw the opportunity to leverage lab test data with other clinical and demographic data to identify patients who were undiagnosed or whose conditions were
Canada faces a similar shortage of medical technologists (MTs) as exists in the United States. “We have reached the point now where some laboratories have been closed for weeks due to insufficient staffing, which is a cascading problem for patients and the healthcare system,” stated Maria Klement, President of the Canadian Society for Medical Laboratory
Pathologists and medical laboratory professionals the world over had a surprise on May 13 if they used Google for an Internet search. The doodle on the Google search home page honored pathologist Dr. Georgios Papanicolaou, who developed the Pap smear test used to screen for cervical cancer.
Papanicolaou was born in 1883 in Greece. He studied medicine in Greece and
CEO SUMMARY: Under guidelines the National Correct Coding Initiative issued last year, many clinical laboratories are not getting paid for some tests. The rates of denial for labs running mostly molecular tests could range from 40% to 100% of revenue, one billing expert said. Implemented Jan. 1, the guidelines apply to labs running tests in
This is an excerpt from a 1,550-word article in the April 8, 2019 issue of THE DARK REPORT. The full article is available to members of The Dark Intelligence Group.
CEO SUMMARY: For two years, clinical lab professionals at WakeMed Health and Hospitals have tested the use of aerial drones to transport patient specimens from a