Tag: pathology services

Dermatologists Say Anthem Cuts Affect Patient Care

CEO SUMMARY: Deep cuts in what Anthem pays pathologists for the professional component for certain AP services are having a harmful effect on the long-standing relationships that dermatologists have with dermatopathologists, some physicians say. By disrupting these relationships, Anthem is harming patient care, they add. Since late last year, in a growing number of states,

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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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AP Groups Can Protect Revenue, Pathologist Compensation

CEO SUMMARY: Many anatomic pathology groups are watching their revenue decline and margins shrink on the same or greater case volume. These trends make it imperative to have a deeper understanding of the operational and financial variables that contribute to stability in the group’s finances and pathologist compensation. One expert on the financial complexity of anatomic

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Nine Lab Groups Say New NCCI Policy Is Inconsistent

CEO SUMMARY: By its name alone, the National Correct Coding Initiative (NCCI) Policy Manual implies that it will be accurate and consistent with other coding initiatives. But nine groups representing various clinical laboratories say NCCI guidelines that the federal Centers for Medicare and Medicaid Services issued in December and implemented on Jan. 1 are inconsistent

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Patient Care Focus Helps Path Group Win Contract

CEO SUMMARY: When Ascension Wisconsin wanted one pathology group to serve its needs statewide, North Shore Pathologists responded to the request for proposal by focusing on how pathologists can improve patient care through a patient-centered model. Other pathology groups responded with proposals that emphasized the financial aspects of the relationship. Focusing on patient care won

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Wisconsin Provides Peek at Pathology’s Future

BIGGER PATHOLOGY GROUPS AND METROWIDE OR STATEWIDE COVERAGE will be major characteristics in the anatomic pathology profession as healthcare continues to transform in new ways. That is why the reasons for the substantial growth in case volume and revenue at North Shore Pathologists (NSP) in Milwaukee should be studied by pathology groups everywhere.

It was a practice

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