Clinical Labs Battle Complex Claims Denials

By Stephen Beale | From the Volume XXXII, No. 11 – August 4, 2025 Issue

CEO SUMMARY: While the number of denials is not going up, the reasons that private payers deny claims are becoming more complex and time-consuming to appeal. After reviewing noteworthy trends among payers, learn a three-level approach to appeals that may lead to greater su…

Read More

---

August 4, 2025, Intelligence: Late-Breaking Lab News

By Robert Michel | From the Volume XXXII, No. 11 – August 4, 2025 Issue

In a filing with the US Securities and Exchange Commission, UnitedHealth Group (UHG) has acknowledged it is under investigation by the US Department of Justice (DOJ). “[UHG] proactively reached out to the Department of Justice after reviewing media reports about investigations into ce…

Read More

---

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…

Read More

---

Quest Acquires ‘Select Assets’ of Fresenius Medical Care

By Robert Michel | From the Volume XXXII, No. 4 – March 10, 2025 Issue

FRESENIUS MEDICAL CARE AND QUEST DIAGNOSTICS AGREED TO A DEAL in which Quest will provide laboratory testing services for the latter’s dialysis clinics in the United States. Separately, Quest Diagnostics will acquire “select assets” of Spectra Labora…

Read More

---

Gold Cards Offer Labs Limited Relief for Prior Auth Woes

By Virchow | From the Volume XXXI, No. 17 – December 16, 2024 Issue

…

Read More

---

Managing Denials and Appeals of Clinical Lab, Path Claims

By Robert Michel | From the Volume XXXI No. 15 – November 4, 2024 Issue

CEO SUMMARY: Based on a study of denials and appeals involving about 20 million lab test claims, the team at XiFin Inc. presents here their findings. They also provide recommendations on steps labs can take to reduce denials and win a greater proportion of appeals. IN RECENT…

Read More

---

Physicians Tempted by Lure of In-Office Labs, Payers Balk

By Virchow | From the Volume XXXI, No. 14 – October 14, 2024 Issue

…

Read More

---

Hurdles Continue When Labs Request Genetic Test Coverage

By Virchow | From the Volume XXXI, No. 13 – September 23, 2024 Issue

…

Read More

---

Labs, Payers Don’t Like Prior Authorization for Genetic Tests

By Robert Michel | From the Volume XXXI, No. 10 – July 22, 2024 Issue

…

Read More

---

How Private Health Insurers May Respond to FDA LDT Regulation

By Virchow | From the Volume XXXI, No. 8 – June 10, 2024 Issue

…

Read More

---