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revenue management

McKesson, Change Healthcare Decide to Create New Company

ACROSS THE NATION, the hundreds of pathology groups and clinical labs that use McKesson Technology Solutions for their billing and collections, along with labs that use the Advanced Diagnostics Solutions group, should pay attention to a major corporate deal announced…

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Understanding the Future Of Laboratory Medicine

CEO SUMMARY: Healthcare’s transformation is now far enough along that most clinical labs and pathology groups are either feeling the financial pain or are excitedly developing ways to deliver more value from lab testing services. On April 26-27, at the 21st annual …

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Price Cuts, Long Delays in Payment Are Expected – December 31, 2012

CEO SUMMARY:  In addition to a steep cut in the 88305 CPT code, anatomic pathology laboratories can expect cuts in the payment from Medicare for molecular and prostate biopsy testing. Two national experts in lab billing and reimbursement warn labs to expect confusion in how both pub…

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At Mid-Year, Labs Struggle to Get Paid for Many Tests

CEO SUMMARY: At a recent coding and billing conference, pathology and lab clients of one of the nation’s largest revenue management companies agreed that three trends have caused lower revenues since the start of 2014. One trend seen by labs involves higher deductibles and copayments fr…

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Labs Have New Hurdles as Some Payments Start

CEO SUMMARY: Some payments are beginning to flow for claims submitted under the new molecular test CPT codes. But there is a new issue. Medicare contractors, Medicaid programs, and private health insurers are deeming certain molecular tests to be medically unnecessary. Th…

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Much Uncertainty About Pay for Molecular Codes

CEO SUMMARY: Having gone unpaid since January 1 for the 114 new molecular CPT codes, many clinical labs and pathology groups have stopped running these tests or laid off staff. Some are considering closing their doors. Evidence indicates that certain Medicare contractors are deciding that…

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Low 2013 Molecular Rates May Bankrupt Some Labs

CEO SUMMARY: Many of the recently issued reimbursement rates for molecular diagnostic tests are inadequate and in fact are lower than the cost of running the tests, lab experts say. Smaller laboratories that specialize in developing and selling molecular tests could be forced to close. As…

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Price Cuts, Long Delays in Payment Are Expected

CEO SUMMARY: In addition to a steep cut in the 88305 CPT code, anatomic pathology laboratories can expect cuts in the payment from Medicare for molecular and prostate biopsy testing. Two national experts in lab billing and reimbursement warn labs to expect confusion in how both public and…

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Using Accurate Data to Grow Lab Outreach

CEO SUMMARY: In recent years, the laboratory outreach program at the Robert Wood Johnson University Hospital in New Brunswick, New Jersey, has achieved impressive rates of growth in specimen volume and net revenue. One reason for this success is that the lab outreach program moni…

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Using Lean to Cut Pap Test TAT Pays Off At Baystate Medical

USE OF LEAN METHODS HAS UNLOCKED major improvements at Baystate Health’s Department of Pathology in Springfield, Massachusetts. One Lean project cut average Pap test turnaround time by more than 50%. Another Lean project attacked errors with Advanced Beneficiary No…

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