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molecular testing

What Labs Need to Do as Payers Audit More Claims

CEO SUMMARY: Attorneys who advise pathologists and clinical laboratories on compliance issues say the number of audits from the government and third-party payers has increased sharply in recent years. In those audits, payers are looking for recoupment of overpayments. A lab’s fai…

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Increasing Costs for Genetic Tests Are Busting Lab Budgets

CEO SUMMARY: Across the nation, hospital administrators are recognizing that effective lab test utilization is a critical factor in a lab’s success. At Seattle Children’s Hospital, clinical pathologists, clinical chemists, and laboratory genetic counselors are …

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Leveraging Testing Technology To Identify MRSA, C. Difficile

CEO SUMMARY: Probably the most challenging infections for hospitals to control and reduce are methicillin-resistant Staphylococcus aureus (MRSA) and Clostridium difficile (C. diff). The laboratory at one New York hospital introduced algorithms to screen for the presence of each i…

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UCLA Pathologists, Radiologists Produce Combined Reports

CEO SUMMARY: To simplify diagnostic reporting, the pathology and radiology departments at the David Geffen School of Medicine/UCLA Medical Center are working together to deliver integrated diagnostic information to treating oncologists. This innovative strategy is designed to im…

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UCLA Pathologists, Radiologists Produce Integrated Diagnostic Lab Reports

CEO SUMMARY: To simplify diagnostic lab reporting, the pathology and radiology departments at the David Geffen School of Medicine/UCLA Medical Center are working together to deliver integrated diagnostic information to treating oncologists. This innovative strategy is designed to…

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More Genetic Counseling Leads to Fewer Lab Tests

CEO SUMMARY: Cigna was the first national health insurer to require independent board-certified genetic counseling before approving coverage for certain genetic tests. Since launching this program in September 2013, the insurer has seen a 450% increase in genetic counseling for Cigna …

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Excluding Lab Competitors Helps Big Labs Grab Greater Market Share

CEO SUMMARY: Changes in healthcare are motivating health insurers and the nation’s largest lab testing companies to enter into contracts in which the large lab company lowers its lab test prices to the payer in return for having the payer exclude that lab company’s toughest competitor…

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New Pricing Formula for Advanced Diagnostic Tests

CEO SUMMARY: One section of the federal H.R. 4302: Protecting Access to Medicare Act of 2014 is getting positive reviews from many lab experts. The law defines advanced diagnostic tests (ADTs) and directs CMS to assign a temporary HCPCS code and use list prices to pay labs for such tests …

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Better Data Needed to Support Pathologists as Consultants

MULTIPLE TRENDS ARE UNFOLDING that mutually reinforce the need for pathologists and PhDs to be experts and consultants in how physicians order and follow up on molecular diagnostics assays and genetic tests. “Healthcare in the United States is approaching a tipping point that can greatly favor pat…

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Two Blood Brothers Report Declines in Revenue-Per-Req

REIMBURSEMENT FOR CLINICAL laboratory testing has declined, particularly for molecular tests. As a consequence, the nation’s two largest laboratory testing companies are feeling the negative effect of lower lab test prices. Both Quest Diagnostics Incorporated and Laborator…

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