Tag: patient record

$26 Million Recoupment from Medicare Audit Hammers Pharmacogenomic Lab

CEO SUMMARY: After Pharmacogenetics Diagnostic Laboratory LLC was audited by a Medicare Zone Program Integrity Contractor (ZPIC), it faced a $26 million repayment demand. The lab company appealed and asked for a redetermination, then filed for Chapter 11 bankruptcy protection. These developments should be a concern to all labs offering pharmacogenomic testing to Medicare patients.

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Quest Makes Second Deal For Inpatient Lab Volume

NEWS OF A HOSPITAL INPATIENT LAB MANAGEMENT AGREEMENT between HealthONE of Denver and Quest Diagnostics Incorporated marks the second time in six months that the public lab company has earned an inpatient lab management pact with a multi-hospital health system.

There are two aspects of this development that make it newsworthy for lab administrators and pathologists

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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 failure to provide proper documentation during these audits can result in the need to pay sixand seven-figure amounts. Payers also are auditing out-of-network billing and patient balance billing.

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Sonora Quest Builds EMPI To Serve Patients and ACOs

CEO SUMMARY: Probably no state has seen a faster transition to ACOs, medical homes, and other types of integrated clinical care organizations than Arizona. Recognizing that this change created a new opportunity to add more value with clinical lab testing services, Sonora Quest Laboratories (SQL) developed an enterprise-wide master patient index. This gives SQL the

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Lab’s Patient-Centric Approach Collects Overdue Money in PSCs

CEO SUMMARY: At Sonora Quest Laboratories (SQL), the ‘Voice of the Customer’ is guiding the organization’s evolution from physician-centric to patient-centric. It was quickly recognized that an effective enterprise master patient index (EMPI) was essential. One patient-centric service that SQL is in the midst of deploying is the capability to collect overdue money owed it

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Hospitals Recognize Need for Uniform Lab Test Data

CEO SUMMARY: Hospitals may soon insist that payers allow their in-house labs to provide outpatient testing regardless of exclusive managed care contracts with national lab companies. The migration to accountable care organizations (ACOs) and medical homes makes it essential that physicians have access to lab data across the entire continuum of care. Standardization of reporting

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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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Patient Service Center Theft Highlights Labs’ Need to Protect Paper Records

LABS PUT SO MUCH EFFORT INTO SECURING electronic health records, that it’s easy to overlook the need to protect paper records. St. Joseph’s Medical Center in Stockton, California, learned this lesson the hard way recently when thieves stole more than 700 paper records from one of the hospital’s 23 patient service centers (PSC).

The theft showed

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