CEO SUMMARY: Evidence shows that adoption of ICD-10 diagnosis codes in 2015 made it possible for health insurers to track clinical laboratory testing more closely, ask more questions about those tests, and deny coverage. Increased detail about each patient’s condition has led to increased demands for medical-necessity documentation and to denied payments of as much
Tag: medical records
This is an excerpt of a 1,484-word article in the Nov. 25, 2019 issue of THE DARK REPORT (TDR). The full article is available to members of The Dark Intelligence Group.
CEO SUMMARY: It’s an unreported trend tracked only by THE DARK REPORT, but which is essential reading for clinical labs and pathology groups that must
CEO SUMMARY: Some of blockchain’s proponents view its potential uses in health information technology to combat cybersecurity threats and improve the secure exchange of health information through electronic medical record systems. But for clinical laboratories, blockchain could be the key to improve payment processes and help eliminate errors in payment and allowed amounts. In theory,
Clinical labs and physicians can soon say goodbye to “meaningful use.” Federal officials are proposing a significant change to the Medicare and Medicaid EHR Incentive program for certified EHRs that has been in existence since 2011. In a press release issued last spring, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule.
MANY LAB EXECUTIVES were concerned last year after a judge in the District of Columbia Circuit Court ruled that clinical laboratories need to determine that all lab test services physicians order are medically necessary.
The court also ruled that ordering physicians do not need to determine medical necessity, noted the law firm McDonald Hopkins in a
This is an excerpt from a 1,300-word article in the March 5, 2018, issue of THE DARK REPORT. The complete article is available for a limited time to all readers, and available at all times to paid members of the Dark Intelligence Group.
CEO SUMMARY: THE DARK REPORT was the first to draw attention to the
DUBAI TO TEST DNA OF ITS 3 MILLION CITIZENS
RECENTLY, GOVERNMENT OFFICIALS in Dubai announced a plan to conduct genetic testing on all three million residents. Experts say this is an unprecedented decision by any national government.
This human genome project will be part of the Dubai 10X initiative. “The authority is looking to target all residents of
CEO SUMMARY: Anthem charged 37-bed Sonoma West Medical Center in Sebastopol, Calif., of engaging in an improper billing scheme to defraud Anthem and its affiliated Blue Cross and Blue Shield plans. In effect, the charge is a notification to SWMC that Anthem intends to sue SWMC and its owner if it does not recover the $13.5 million in a timely
CEO SUMMARY: Members of Joint Venture Hospital Laboratories in Michigan anticipate that the 2018 Clinical Laboratory Fee Schedule rates being implemented under PAMA will lower payment from Medicare to less than the cost of running tests, especially for rural and critical access hospitals. CMS established the 2018 CLFS under the Patient Access to Medicare Act
CEO SUMMARY: In the latest chapter of an explosive case at the University of Kansas Medical Center that includes claims of a cancer misdiagnosis, an unnecessary surgery, and a cover-up that involves the former chair of pathology, the patient has sued for fraud, negligence, and civil conspiracy. After a whistle-blowing pathologist filed an earlier lawsuit,