TAG:
UnitedHealthcare
Private Health Insurers Are Aware of Problems with CPT Code 81408
EDITOR’S NO…
UHC Will Delay Enforcement of Z-codes for Genetic Test Claims
IN THE LATEST BACKPEDAL ON ITS NEW POLICY, UNITEDHEALTHCARE (UHC) appears to have dropped its requirement for genetic testing laboratories to use Z-codes for claims under commercial health plans—for now. Earlie…
Smaller Labs Must Verify Z-code Arrangement with Lab Companies
EDITOR’S NO…
With Z-codes, Will Other Payers Follow UnitedHealthcare’s Lead?
EDITOR’S NOT…
HCCI Reports Higher Prices for Hospital Outreach Tests
CEO SUMMARY: It’s another shot across the bows to hospital and health systems that use inpatient test prices when billing health insurers for outpatient/outreach lab tests. In its report, the Health Care Cost Institute documents how these hospital l…
Technical Assessment Challenges for Z-Code Applications
CEO SUMMARY: Effective on Aug. 1, UnitedHealthcare will require Z-code submissions for many genetic tests. During a recent webinar, experts tackled a topic that may prove troublesome for labs seeking Z-codes: technical assessments. Key advice is to provide specific data about clin…
UnitedHealthcare’s Z-code Policy Starts on Aug. 1
CEO SUMMARY: UnitedHealthcare’s (UHC) response to the ever-growing number of unique genetic tests and the continuing growth in the volume of those claims is a new policy. Effective Aug. 1, UHC will require a Z-code with genetic test claims. This req…
Stressful Weeks Ahead for Labs Thanks to Z-codes
We are not alone in recognizing that UnitedHealthcare’s…
Optum and Avalon Discuss Genetic Test Claims Review
CEO SUMMARY: With the ever-increasing number of genetic tests on the market, payers are understandably frustrated with genetic test claims that don’t clearly outline the medical need for a procedure or it…
Expect More Z-code Requirements for Genetic Tests
GENETIC TESTING COMPANIES ARE STILL REACTING TO LAST MONTH’S NEWS that one of the nation’s largest health insurers—UnitedHealthcare (UHC)—will require Z-codes for molecular test claims submitte…
CURRENT ISSUE
Volume XXX, No. 13 – September 11, 2023
Recent court rulings involving the No Surprises Act are putting the government on the defensive about provisions of the law. Also, the continued consolidation of the IVD and national laboratory company markets has brought more influence to those lab companies. In addition, learn how clinical labs can earn money from their diagnostic data by helping private insurers navigate Medicare Advantage’s risk adjustment model.
See the full table of contentsHow Much Laboratory Business Intelligence Have You Missed?
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