TAG:
private payer audit
Payers Unleash AI to Dissect Outlier Billing Patterns
Diagnostic laboratories can follow every clinical guideline, employ the most talented clinical lab professionals, and provide life-saving data to patients, yet still find themselves in the crosshairs of a federal or payer audit. The culprit is …
Behind-the-Scenes Audits Often Hide Cause of Test Claim Denials
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How Private Payers Audit Labs for Possible Claims Fraud
EDITOR’S NOT…
CURRENT ISSUE
Volume XXXIII, No. 8 – June, 2026
Congress Returns to CLIA Reform with Proposed LDT Framework, and the Newly Filed Enhancing CLIA Act seeks to modernize clinical laboratory regulations. A newly introduced federal bill could signal the next chapter in the long-running debate over how laboratory developed tests (LDTs) should be regulated in the United States.
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