TAG:
RCM
Behind the Cat-and-Mouse Game of Lab Reimbursement
Financial relationships between clinical laboratories and commercial payers have evolved into a high-stakes, technological tug-of-war. For nearly a decade, the clinical laboratory industry has wrestled with the provisions of the Protecting Acce…
Report Identifies Practices of Top RCM Performers
Revenue cycle management (RCM) can be a headache for all healthcare providers, including clinical laboratories and anatomic pathology practices. However, some organizations handle the challenges better than others. This was the key takeaway fro…
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 …
Why Labs Must Rethink Audit Readiness in 2026
CEO SUMMARY: Doing everything right is no longer enough to ensure claims are paid. With AI-driven audits on the rise, lab leaders must ensure their organizations can prove compliance—quickly, clearly, and consistently. Based on commentary from RCM experts Ann Lambrix and…
Revenue Concerns to Watch at Home and Abroad
This issue of The Dark Report explores…
RCM Automation Helps Lab Manage Billing Headaches
CEO SUMMARY: In an era where it is widely suspected that private payers are using artificial intelligence to review and deny diagnostic test claims, Southwest Labs in New Mexico decided to fight back. The organization worked with RCM firm Wuscott to figure out why claims w…
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…
Optum Adds Gestalt to Its Digital Diagnostic Suite
CEO SUMMARY: This development signals Optum’s intent to be a player in digital pathology. Its deal with Gestalt Diagnostics adds a pathology solution to Optum’s existing suite of cloud-based services for managing digital images generated by cardiology, radiology, and hematology-oncolo…
Optum Adds Gestalt to Its Digital Diagnostic Suite
CEO SUMMARY: This development signals Optum’s intent to be a player in digital pathology. Its deal with Gestalt Diagnostics adds a pathology solution to Optum’s existing suite of cloud-based services for managing digital images generated by cardiology, radiology, and hematology-oncolo…
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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