TAG:
UnitedHealthcare
For Labs, a Little Angel and Devil Sit Behind Z-Codes
Much lies underneath the surface of UnitedHealthcare’s (UHC) new policy mandating Z-code use for molecular tests covered under its commercial health plans. It’s a developme…
UHC’s Z-Code Requirement to Commence on Aug. 1
CEO SUMMARY: In what may be an alarming development for certain clinical laboratories, as of Aug. 1, UnitedHealthcare will require Z-codes for molecular test claims filed under its co…
UnitedHealthcare Policy Change Requires NPI Numbers on Medicare Advantage Claims
ANOTHER NEW POLICY RECENTLY ANNOUNCED by UnitedHealthcare (UHC) sets a deadline for June 1, 2023, requiring clinical laboratories and other ancillary providers to include the …
Payers Request More Claims Documentation
CEO SUMMARY: Both anecdotal evidence from lab professionals and numbers-based data from XiFin point to a problem: More payers require clinical labs to produce more documentation that a test claim i…
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…
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Volume XXXI, No. 6 – April 29, 2024
Laboratory managers will want to note that The Dark Report itself was targeted by the fraudsters who hit Change Health in a cyberattack. Also, one lab has some innovative methods of combatting the chronic staffing shortage, including hiring college graduates and students.
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