Gold Cards Offer Labs Limited Relief for Prior Auth Woes

By Virchow | From the Volume XXXI, No. 17 – December 16, 2024 Issue

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Labs, Payers Don’t Like Prior Authorization for Genetic Tests

By Robert Michel | From the Volume XXXI, No. 10 – July 22, 2024 Issue

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Payers Are Right to Be Wary of Claims for Some LDTs’ Value

By Virchow | From the Volume XXX, Number 17 – December 4, 2023 Issue

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UnitedHealthcare’s Z-code Policy Starts on Aug. 1

By Robert Michel | From the Volume XXX, No. 10 – July 10, 2023 Issue

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…

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Payers Request More Claims Documentation

By Robert Michel | From the Volume XXX, No. 7 – May 8, 2023 Issue

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…

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Six Important Themes to Help Labs Succeed

By Scott Wallask | From the Volume XXX, No. 5 – March 27, 2023 Issue

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…

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Eight Macro Trends for Clinical Labs in 2023

By Robert Michel | From the Volume XXX, No. 1 – January 3, 2023 Issue

CEO SUMMARY: Laboratory administrators and pathologists will want to carefully study eight important trends that will guide their business strategies in 2023. Many of these macro trends center on financial and operational difficulties and ways to steer around these obstacles. Anothe…

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How Genomic Testing Labs Can Improve Their Relationships with Payers

By Robert Michel | From the Volume XXIX, No. 14 – October 10, 2022 Issue

CEO SUMMARY: For payers and health plans, it may be a matter of trust that initially curtails speedy reimbursement of new and novel genomic test claims. A panel …

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Optum to Offer Laboratory Benefits Management to other Health Plans

By Robert Michel | From the Volume XXIX, Number 9 – June 27, 2022 Issue

This is an excerpt of a 1,355-word article in the June 21, 2022 issue of  THE DARK REPORT. The full article is available to members of The Dark Intelligence Group. CEO SUMMARY: UnitedHealth Group subsidiary Optum announced a new laboratory benefits management program aimed at impr…

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UnitedHealth’s Optum to Offer Lab Test Management

By Robert Michel | From the Volume XXIX, Number 9 – June 27, 2022 Issue

CEO SUMMARY: UnitedHealth Group subsidiary Optum announced a new laboratory benefits management program aimed at improving utilization of genetic/molecular clinical laboratory testing. The goal is to save health plans money while bringing genetic test validity data prominently into …

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