TAG:
revenue cycle
ICD-10 Gives Payers More Data About Lab Claims
CEO SUMMARY: Evidence shows that adoption of ICD-10 diagnosis codes in 2015 made it possible for health insurers to track clinical laboratory testing more closely, ask more questions about those tests, and deny coverage. Increased detail about each patient’s condition has led to increas…
ICD-10 Codes Give Payers More Data About Lab Claims
This is an excerpt of a 1,484-word article in the Nov. 25, 2019 issue of THE DARK REPORT (TDR). The full article is available to members of The Dark Intelligence Group. CEO SUMMARY: It’s an unreported trend tracked only by THE DARK REPORT, but which is essential reading for clinical …
Aetna Ends Payment for Professional Component
CEO SUMMARY: As of Aug. 1, Aetna will stop paying out-of-network pathologists for the professional component review of certain clinical pathology tests. Until now, the health insurer has paid for the professional component when out-of-network labs billed for clinical lab tests using the m…
AP Groups Can Protect Revenue, Pathologist Compensation
CEO SUMMARY: Many anatomic pathology groups are watching their revenue decline and margins shrink on the same or greater case volume. These trends make it imperative to have a deeper understanding of the operational and financial variables that contribute to stability in the group’s fi…
Senator Asks: Are Lab Test Payments Too High?
CEO SUMMARY: It is ironic that, after the federal Centers for Medicare and Medicaid Services (CMS) enacted the deepest price cuts to the Part B Clinical Laboratory Fee Schedule in more than 50 years, a U.S. Senator now asks CMS why it will pay billions more for lab testing. The question f…
Useful Lessons for Labs That Report PAMA Data
CEO SUMMARY: Will clinical labs heed the lessons learned from the first PAMA private payer market price reporting cycle that CMS conducted in 2017? One major difference is that the definition of applicable laboratories now includes most hospital labs. This creates the opportunity for a la…
Critical Lessons for Labs That Report PAMA Medicare Data
This is an excerpt from a 1,565-word article in the Feb.4 issue of THE DARK REPORT. The full article is available to paid members of The Dark Intelligence Group. CEO SUMMARY: With most hospitals now included as “applicable laboratories” in the PA…
CEO Offers Lab Strategies for a Post-PAMA World
CEO SUMMARY: With so many market forces working against the economic interests of clinical laboratories, it is essential that all labs develop appropriate strategies designed to sustain the quality of laboratory testing services and the financial integrity of the laboratory organization. …
Inconsistent Billing Causes Patients to Find New Providers
THERE IS A NEW SOURCE OF LOST BUSINESS for physicians, clinical laboratories, and others. Patients are losing patience with confusing bills from their providers and opting to find new providers who offer simple, clear, and consistent bills. This turnover in patients was one key finding in a recently-…
October 9, 2017 Intelligence: Late Breaking Lab News
Sept. 22 was the day that an agreement to sell Miraca Life Sciences (MLS) of Irving, Texas, was announced. Miraca Holdings will sell the anatomic pathology lab company to Avista Capital Partners. As part of the transaction, a new holding company, cal…
CURRENT ISSUE
Volume XXX No. 4 – March 6, 2023
Readers will uncover a theme of mergers and consolidations running throughout this issue of The Dark Report. Case in point is our story about the pending merger between Sanford Health and Fairview Health Services. If the deal goes through, the new system will have 58 hospitals across five states. The Dark Report also notes revenues from Labcorp’s acquisition of Ascension Health, and reports on the creation of a major MT training center in Utah.
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