CEO SUMMARY: With each passing year, the primary role of hospital and health system labs evolves in a different direction than that of independent lab companies. This trend is a response to the creation of integrated delivery networks paid on value and how they are scored on their ability to keep patients out of hospitals
Tag: patient record
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.
This is an excerpt from a 1,340-word article in the January 9 issue of THE DARK REPORT. The complete article is available for a limited time to all readers, and available at all times to paid members of the Dark Intelligence Group.
CEO SUMMARY: Pharmacogenomic testing is expected to be a linchpin to the practice of precision
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
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.
People walking down a street in Weatherford, Connecticut on March 10, found lab test reports for at least 16 patients, according to a news report by a local television news station. This is a breach of protected health information (PHI) under the federal HIPAA statute. Reporters from WSFB contacted one of the patients whose lab
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
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
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
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