TAG:
Prior authorization
AI Reshapes Job Market: New Priorities for Clinical Labs
Artificial intelligence (AI) is no longer a future consideration in the job market. Instead, it is actively reshaping how professionals find work, how roles are defined, and which skills employers value most. According to recent LinkedIn resear…
Clinical Labs Battle Complex Claims Denials
CEO SUMMARY: While the number of denials is not going up, the reasons that private payers deny claims are becoming more complex and time-consuming to appeal. After reviewing noteworthy trends among payers, learn a three-level approach to appeals that may lead to greater su…
Don’t Let the Payers Enjoy All the Benefits of Data
PROBABLY SINCE THE ADVENT OF M…
UnitedHealth Group Heads into Difficult Waters Mid-Year
WITH THE NEWS THAT THE FORMER HEAD OF UNITEDHEALTH GROUP (UHG) has returned after the sudden resignation of the company’s CEO, it is apparent that pressure on the healthcare company continues to mount. This latest twist comes on top of a bad…
Gold Cards Offer Labs Limited Relief for Prior Auth Woes
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Labs, Payers Don’t Like Prior Authorization for Genetic Tests
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Payers Are Right to Be Wary of Claims for Some LDTs’ Value
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UnitedHealthcare’s Z-code Policy Starts on Aug. 1
CEO SUMMARY: UnitedHealthcare’s (UHC) response to the ever-growing number of unique genetic tests and the continuing growth in the volume of those claims is a new policy. Effective Aug. 1, UHC will require a Z-code with genetic test claims. This req…
Payers Request More Claims Documentation
CEO SUMMARY: Both anecdotal evidence from lab professionals and numbers-based data from XiFin point to a problem: More payers require clinical labs to produce more documentation that a test claim i…
Six Important Themes to Help Labs Succeed
CEO SUMMARY: Clinical laboratories face business challenges with day-to-day operations, genetic testing, and evolving care delivery models. The 2023 Executive War College on Diagnostics, Clinical Laboratory, and Pathology Management returns on April 25-26 in New Orleans. Participant…
CURRENT ISSUE
Volume XXXIII, No. 4 – March 23, 2026
A federal court ruling has established a safe harbor for clinical labs when they run tests ordered by physicians. Lab leaders should examine this briefing for pitfalls. Also, it turns out that providers may be ordering inappropriate vitamin D tests, according to one expert.
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