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Medicare Advantage

Quest Acquires ‘Select Assets’ of Fresenius Medical Care

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…

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Gold Cards Offer Labs Limited Relief for Prior Auth Woes

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Managing Denials and Appeals of Clinical Lab, Path Claims

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…

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

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Hurdles Continue When Labs Request Genetic Test Coverage

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

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How Private Health Insurers May Respond to FDA LDT Regulation

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UnitedHealth Group Faces DOJ Antitrust Probe

CEO SUMMARY: Recent events have not been kind to UnitedHealth Group and its subsidiaries UnitedHealthcare and Optum. In February, just as UHG’s Change Healthcare division was hit with a major cyberattack that disrupted billions of dolla…

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Payer Contracts with Labs: Getting the Contract Is Just the Start

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CMS Issues AI Guidance for Medicare Advantage

CEO SUMMARY: With its guidance on how Medicare Advantage plans should use artificial intelligence (AI) when making treatment decisions involving individual patients, the federal Centers for Medicare and Medicaid Services has opened one door in the coming debate on how the federal governme…

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