TAG:

procedure code

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…

Read More



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…

Read More



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 …

Read More



Nine Lab Groups Say New NCCI Policy Is Inconsistent

CEO SUMMARY: By its name alone, the National Correct Coding Initiative (NCCI) Policy Manual implies that it will be accurate and consistent with other coding initiatives. But nine groups representing various clinical laboratories say NCCI guidelines that the federal Centers for Medicare a…

Read More



Expert Explains Why Payer Errors Skew Labs’ PAMA Price Data

CEO SUMMARY: In its work with more than 200 lab clients, XIFIN, Inc., of San Diego, sees the best and worst of problems in how labs submit claims to lab tests and how payers process these claims. In this exclusive interview, Lâle White, XIFIN’s Founder and CEO, identifies the systemic …

Read More



Widespread payer errors will cause headaches as Protecting Access to Medicare Act of 2014 price reporting comes due

This is an excerpt from a 2,700-word article in the November 28 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. …

Read More



Pathologists Contribute To Care in Wisconsin ACO

CEO SUMMARY: From the launch in 2013 of a big accountable care organization in Wisconsin, the North Shore Pathologists at Columbia-St. Mary’s Hospital have been involved. Among the lessons learned are the importance of structuring the pathology contract with the hospital to antic…

Read More



Florida Doc Says Questions Go Unanswered by UHC

CEO SUMMARY: One common complaint about the efforts of UnitedHealthcare to introduce its unpopular laboratory benefit management program in Florida is that the insurer-and its agent, BeaconLBS, a division of Laboratory Corporation of America-don’t respond to physicians when they …

Read More



Numerous Issues Identified With Bid Demo’s 303 Tests

CEO SUMMARY: One experienced expert in billing and coding was surprised at the list of 303 tests to be included in the Medicare Laboratory Competitive Bidding Demonstration Project. He notes that the list of 303 tests includes a number of codes and descriptions that are not consistent wit…

Read More



How Local Path Groups Can Keep Patient Access

CEO SUMMARY: For pathology groups operating their own histology and cytology labs, a growing problem is access to patients covered by exclusive managed care contracts. In the Northeast, several persistent pathology group practices are using some effective business strategies to fight this…

Read More



How Much Laboratory Business Intelligence Have You Missed?

Lab leaders rely on THE DARK REPORT for actionable intelligence on important developments in the business of laboratory testing. Maximize the money you make-and the money you keep! Best of all, it is released every three weeks!

Sign up for TDR Insider

Join the Dark Intelligence Group FREE and get TDR Insider FREE!
Never miss a single update on the issues that matter to you and your business.