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xifin

Comment Period Closing on Federal Surprise Billing Rule

PATHOLOGY GROUPS AND CLINICAL LABS HAD UNTIL SEPTEMBER 7 to comment on an interim final rule that provides federal protections against surprise billing and limits out-of-network (OON) cost sharing under many of the circumstances in which surprise bills arise most frequently….

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September 7, 2021 Intelligence: Late-Breaking Lab News

New diagnoses of cancer in the United States fell by almost 30% in the early months of the SARS-CoV-2 pandemic. That’s one conclusion in a paper authored by Quest Diagnostics and published on Aug. 31, in JAMA Network Open. Quest looked at the new diagnoses of eight common types of can…

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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…

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XIFIN to Open New Office in South Carolina for Lab Billing

SINCE FEBRUARY, THE TOTAL NUMBER OF PEOPLE VACCINATED grew steadily even as the number of tests for COVID-19 declined sharply in the United States. But overall test volume has remained steady at 130% of pre-pandemic levels, said Brian Kemp, Vice President of Revenue Cycle Operations for XIFIN,…

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Benefits Investigation Is Growing Issue for Genetic Testing Labs

QUIETLY AND WITH LITTLE NEWS COVERAGE, a new complication is challenging clinical laboratories that offer genetic testing. It involves a steady growth in the number of patients who do a “benefits investigation” before allowing their physician to order a genetic test….

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From Mid-March, Labs Saw Big Drop in Revenue

CEO SUMMARY: In response to the coronavirus outbreak, patients stopped seeing their doctors for routine care and hospitals ceased doing elective services. With fewer test referrals, clinical labs and pathology groups were hit with a substantial decline in revenue. One of t…

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How Labs Can Add Value for Providers, Insurers, Pharma

CEO SUMMARY: For pathologists and clinical, molecular, and genetic testing labs, appropriate reuses of lab data can provide a new source of revenue. Labs that serve as preferred providers of diagnostic testing data can help health systems, ordering physicians, pharmaceutical companies, an…

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What Labs Can Expect from PAMA in 2019

CEO SUMMARY: Attendees at the Executive War College learned that CMS has taken steps to expand the number of hospital labs required to report their private payer lab test price data under the Protecting Access to Medicare Act, but the unbundling of certain test panels could be problematic…

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Labs Get High Denial Rates Under New NCCI Rules

CEO SUMMARY: Under guidelines the National Correct Coding Initiative issued last year, many clinical laboratories are not getting paid for some tests. The rates of denial for labs running mostly molecular tests could range from 40% to 100% of revenue, one billing expert said. Implemented …

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Best Ways to Gather, Access, Report PAMA Price Data to CMS

CEO SUMMARY: All clinical labs required to report their private payer lab test price data are now in the midst of collecting that data. One big change in PAMA reporting is that the federal Centers for Medicare and Medicaid Services now defines most hospital and health system labs as “ap…

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