Tag: pathology billing

Aetna, Anthem to Pay Pathology Groups Less

TWO OF THE NATION’S LARGER HEALTH INSURERS—AETNA AND ANTHEM— ARE CUTTING WHAT THEY PAY for the professional component of certain clinical and anatomic pathology codes.

In its communications with pathology groups about this policy change, Aetna says it will no longer pay for most clinical laboratory claims submitted with the modifier 26 for professional component services.

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Improve Your AP Group’s Financial Performance

CEO SUMMARY: Across the nation, health insurers are paying less for anatomic pathology services. This shrinks pathology group revenue and reduces pathologist compensation. Savvy pathology groups are responding to this trend by reviewing long-standing processes in their coding, billing, and collections department. Their goal is to update these billing and collections processes in ways that

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Four Labs and Billing Company Pay $140,000 Fine in HIPAA Case

WHEN A BILLING SERVICE company disposes of patients’ lab test records, it should do so in compliance with federal and state privacy rules. That means all protected health information (PHI) should be shredded or incinerated.

Four pathology groups in Massachusetts learned this lesson the hard way when they and their billing company agreed to pay collectively

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Changed Medicare Policy Adds to Regulatory Risk

CEO SUMMARY: When Medicare’s National Correct Coding Initiative (NCCI) manual took effect on January 1, 2012, it contained a significant change in how prostate biopsy claims are to be coded. This change was widely overlooked by the pathology profession and even dismissed entirely for its ambiguity and inconsistency with previously published guidance on the subject.

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How Labs Should Comply With New Signature Rule

CEO SUMMARY: Across the nation, clinical laboratories and pathology groups are reacting to the new Medicare rule that requires a physician signature on a paper requisition for clinical laboratory tests. Laboratories using paper requisitions will need to add a signature line, then print and distribute these new requisitions to their clients. Pathologists and lab administrators

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Clarient, Generation Health, GenMark, Osmetech, Laboratoire Cerba, UCLA Med Center

CLARIENT INKS PACT WITH GENERATION HEALTH FOR GENETIC TESTING
PAYER PRE-AUTHORIZATION OF GENETIC TESTS is the reason for the newly-announced contract between Clarient, Inc., and Generation Health, Inc., of Upper Saddle River, New Jersey.

Announced on June 10, the agreement positions Clarient to be the preferred provider of genetic tests for Generation Health. Generation Health was founded

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