TAG:
UnitedHealthcare
Coverage, Reimbursement Still Difficult for New Lab Tests
CEO SUMMARY: Bringing a new proprietary diagnostic test to market is an arduous process. It takes patience and planning to complete the journey from test development to payer reimbursement. This slow process stems from the fact that the healthcare reimbursement system is fragmented,…
Optum to Offer Laboratory Benefits Management to other Health Plans
This is an excerpt of a 1,355-word article in the June 21, 2022 issue of THE DARK REPORT. The full article is available to members of The Dark Intelligence Group. CEO SUMMARY: UnitedHealth Group subsidiary Optum announced a new laboratory benefits management program aimed at impr…
UnitedHealth’s Optum to Offer Lab Test Management
CEO SUMMARY: UnitedHealth Group subsidiary Optum announced a new laboratory benefits management program aimed at improving utilization of genetic/molecular clinical laboratory testing. The goal is to save health plans money while bringing genetic test validity data prominently into …
UnitedHealth’s Lab Test Registry Implementation Delayed Again
ANOTHER DELAY WAS ANNOUNCED FOR IMPLEMENTATION of UnitedHealthcare’s Laboratory Test Registry Protocol, which requires clinical laboratories to register each of their tests with the health insurer. This latest delay likely is the result of operational issues on behalf of the managed care com…
Insurers Get Aggressive with Years-Old Audits, Searching for Lab Overpayments
This is an excerpt of a 1,971-word article in the July 26, 2021 issue of THE DARK REPORT (TDR). The full article is available to members of The Dark Intelligence Group. CEO SUMMARY: Not only are health insurers looking back to find lab overpayments and funds paid erroneously, but…
Insurers Get Aggressive with Years-Old Audits
CEO SUMMARY: Not only are health insurers looking back to find overpayments and funds paid erroneously, but payers also are requiring documentation for overpayments. If clinical labs and anatomic pathology groups do not appeal such claims quickly, they may be liable for any amount i…
How to Achieve Success with Genetic Test Prior Authorization
AS MANAGED CARE PAYERS INCREASINGLY REQUIRE PRIOR AUTHORIZATION FOC GENETIC TESTS, clinical laboratories should understand the ins and outs of what it takes to get reimbursed for testing they provide. Almost all payers now require prior authorization (P…
Interesting New Surprises for Lab Leaders
Unexpected and surprising things continue to happen in the clinical laboratory industry. You might consider that to be one unifying theme to the intelligence briefings we present in this issue of The Dark Report. For example, a…
Genesis Lab Lawsuit Pursues UnitedHealth Over Unpaid Test Claims
This is an excerpt of a 1,946-word article in the July 6, 2021 issue of THE DARK REPORT (TDR). The full article is available to members of The Dark Intelligence Group. CEO SUMMARY: New case law in how health insurers should reimburse for COVID-19 lab test claims might be one outc…
NJ Lab Sues UnitedHealth Over Unpaid Test Claims
CEO SUMMARY: New case law in how health insurers should reimburse for COVID-19 lab test claims might be one outcome if a New Jersey lab company were to prevail in a federal lawsuit it filed against UnitedHealthcare alleging non-payment of COVID-19 test claims. An interesting fact me…
CURRENT ISSUE
Volume XXIX, No. 11 – August 8, 2022
This issue examines the challenges facing the nation’s hospitals, health systems, and clinical labs: unprecedented shortages of lab staff, nurses, and other professionals with inflation-fueled cost increases and deteriorating hospital finances. Also, the issue delivers a case study showing how Bryan Health in Nebraska expanded its lab outreach program to include direct-to-consumer tests.
See the full table of contentsHow Much Laboratory Business Intelligence Have You Missed?
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