View My Shopping Cart

Getting Paid for Molecular Tests:
How Clinical Laboratories and Pathology Groups Should Respond to Pre-Authorization Requirements by Payers

FREE Special Edition White Paper

Free White Paper

Download Your FREE Special Report Today!
Simply Complete the Form Below


Getting Paid for Molecular Tests: How Clinical Laboratories and Pathology Groups Should Respond to Pre-Authorization Requirements by PayersThe proliferation of molecular diagnostics is bringing a tidal wave of complexity, cost and quality issues for payers, clinicians and laboratories. Although clinical laboratory testing costs represent only 3 percent of total health care costs, diagnostic testing influences 70 percent of all health care decisions.  Therefore, payers are accelerating efforts to appropriately manage the utilization and reimbursement of molecular diagnostics and genetic tests. Payer initiatives include developing utilization management programs, such as pre-authorizations r notifications, to identify genetic and molecular tests using stacked codes, ensure medical appropriateness, and encourage increased use of in-network laboratories.

Payers will likely require pre-authorization/ notification for clinical laboratories and pathology groups, just as they have done for radiology.  To stay ahead of evolving requirements, successful laboratories are deploying technology to collaborate real-time with clinicians, payers and other laboratories. In addition to making payer rules, benefits and coverage policies transparent to ordering clinicians, patients and laboratories at the point of care (or within the context of an order, successful technology deployments enable early adopters to further penetrate their market, increase clinician loyalty and better manage their utilization and relationships with payers.

The Dark Report is happy to offer our readers a chance to download our recently published FREE White PaperGetting Paid for Molecular Tests: How Clinical Laboratories and Pathology Groups Should Respond to Pre-Authorization Requirements by Payers” at absolutely no charge.  This free download will provide readers with a detailed overview of current legal challenges that your lab may encounter in the near future.


Free White Paper

Here is just some of what you will take away…

  1. Why Payer Pre-Authorization and/or Notification for Genetic Molecular Tests Will Become Widespread
  2. The Advantages of Automated Payer Communication
  3. A Systematic Approach to Evaluating Genetic and Molecular Test Claims
  4. For more about How Clinical Laboratories and Pathology Groups Should Respond to Pre-Authorization Requirements, please CLICK HERE

Free White Paper

Table of Contents

Introduction

Chapter 1. Current Status of Managed Care Requirements for Coding, Claim Submission and Reimbursement of Molecular Tests

Chapter 2.
Why Payer Pre-Authorization and/or Notification for Genetic Molecular Tests Will Become Widespread

Chapter 3.
Existing Differences Among Payers in Pre-Authorization of Genetic and Molecular Tests

Chapter 4.
Advantages of Automated Payer Communication

Chapter 5.
A Systematic Approach to Evaluating Genetic and Molecular Test Claims

Chapter 6.
Case Study: Improving Clinical, Operational and Financial Performance in the Laboratory

Chapter 7.
Conclusion

A-1 About Matthew Zubiller
A-2 About McKesson
A-3 About DARK DAILY
A-4 About The Dark Intelligence Group, Inc., and The Dark Report
A-5 About Executive War College on Laboratory and Pathology Management
A-6 About Karen Appold

Terms of Use — Page 36

Free White Paper

 

 

Copyright © 2017-2019 the Dark Intelligence Group, Inc. All rights reserved. Reproduction in whole or part without permission is prohibited. We Value Your Privacy! The Dark Intelligence Group will never sell, rent or otherwise abuse your email address. It will be used solely for the purpose of sending you the Dark Daily newsletter and updates about the Dark Daily. Should you wish to unsubscribe at any time, instructions are included with each email for immediate removal from the Dark Daily newsletter subscriber file.