TAG:
private payer
Artificial Intelligence and Executive War College
By the time you read this our 29th annual Executive W…
Why Payers Bristle as Labs Submit Inpatient Fees for Outreach Tests
EDITOR’S NOTE: Our column, Virchow, is written…
Experts Discuss Genetic Test Claim Review
GENETIC TESTING LABORATORIES CAN EXPECT PRIVATE HEALTH INSURERS to require better data about the accuracy and clinical relevance of the genetic test claims being s…
January 6, 2020 Intelligence: Late Breaking Lab News
On Dec. 19, Congress passed a year-end spending bill that included the Laboratory Access for Beneficiaries (LAB) Act. The bill went to the President for his signature. The bill mandates that the federal Centers or Medicare and Medicaid Services (CMS) delay by one year having labs rep…
Bill Would Delay PAMA Reporting for One Year
CEO SUMMARY: For all laboratories that must report private payer price data under the Protecting Access to Medicare Act (PAMA), a new bill in congress would delay the next round of data reporting for one year and require the National Academy of Medicine to recommend ways to improve the da…
What Labs Can Expect from PAMA in 2019
CEO SUMMARY: Attendees at the Executive War College learned that CMS has taken steps to expand the number of hospital labs required to report their private payer lab test price data under the Protecting Access to Medicare Act, but the unbundling of certain test panels could be problematic…
“I’m from the Government, and I’m here to help.”
Across the nation, clinical laboratories struggle to correctly interpret and follow the new National Correct Coding Initiative (NCCI) guidelines that took effect on Jan. 1. A financial disaster lies ahead for many labs. “The denials are very high right now and those denials are nationwide,” stat…
Labs Get High Denial Rates Under New NCCI Rules
CEO SUMMARY: Under guidelines the National Correct Coding Initiative issued last year, many clinical laboratories are not getting paid for some tests. The rates of denial for labs running mostly molecular tests could range from 40% to 100% of revenue, one billing expert said. Implemented …
LabCorp to Acquire Iowa’s Metropolitan Medical Lab
CEO SUMMARY: Without making an announcement, LabCorp said it would acquire the Metropolitan Medical Laboratory, a privately-held laboratory founded in 1914 in Davenport, Iowa. The local newspaper reported that some 136 employees from Metro Medical’s laboratory operations in Moline, Ill….
Best Ways to Gather, Access, Report PAMA Price Data to CMS
CEO SUMMARY: All clinical labs required to report their private payer lab test price data are now in the midst of collecting that data. One big change in PAMA reporting is that the federal Centers for Medicare and Medicaid Services now defines most hospital and health system labs as “ap…
CURRENT ISSUE
Volume XXXII, No. 8 – June 2, 2025
The leveraging of data is very important for creating laboratory and healthcare efficiencies. In an exclusive interview with The Dark Report, Bradley Bostic, founder, chair, and CEO of healthcare and laboratory data intelligence Company HC1, discusses trends in healthcare, how to position clinical laboratories as a strategic asset, and ways to analyze diagnostic data to improve efficiency and increase the bottom line.
See the full table of contentsHow Much Laboratory Business Intelligence Have You Missed?
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