Recently published White Paper explores effective new ways for clinical labs and pathology groups to reverse the trend of uncollected revenue in an era of higher patient requirements and reimbursement pressures

As a result of the drive toward consumer-driven healthcare, and because of rising health insurance deductibles, patients are increasingly becoming the new payers. Efficient patient access management is now viewed as critical to reversing the resulting trend of uncompensated care, and to meeting the lab’s revenue cycle objectives. As patients take on more risk and assume more of their own healthcare costs, and as registration errors, authorization, and medical necessity continue to contribute...

Results of Harvard Study into Medicare Costs Offers Opportunities for Clinical Laboratories

Harvard’s study of high-cost Medicare patients offers insights into how medical laboratories can help improve early diagnosis, optimize therapies, and monitor chronic disease Clinical laboratories and anatomic pathology groups supporting Medicare patients understand that a small portion of high-cost patients make up the majority of Medicare spending. Between extended treatment, comorbidities, and the complex nature of disease therapies, chronic illnesses have a major impact on healthcare...

Sonic Healthcare Uses Test Data to Create Shared Savings Opportunities for Clinical Laboratory and Providers

Sonic’s data-driven approach to population health management, based on helping clinicians intervene with patients to control healthcare costs, increases the lab’s revenue Sonic Healthcare USA is using clinical laboratory test data to help its client providers improve population health. This effort also has allowed the Austin, Texas-based lab company to share in the savings one provider client received from the Medicare Shared Savings Program. Using integrated financial and clinical analytics,...

Reimbursement Expert Advises Pathologists and Hospitals to Ensure Part A Contracts Are Balanced and Reflect Both Fair Market Value and Commercial Reasonableness

When negotiating an effective Part A contract for professional pathology services, the best approach is to structure an agreement that is fair and reasonable to both the hospital and the pathologist. That’s the advice given by Robert Tessier, Senior Reimbursement Consultant, HBP Services, Inc. in an interview with Dark Daily. In his position with the Woodbridge, Conn.-based management consulting firm, Tessier advises hospitals on their contracts with pathology groups (HBP stands for...

FDA Authorizes 23andMe to Report Results of Direct-to-Consumer Pharmacogenetics Test to Customers without a Prescription, Bypassing Doctors and Clinical Laboratories

FDA cautions patients to not use data gained from the DTC test to make healthcare decisions on their own Clinical laboratories continue to be impacted by the growing direct-to-consumer (DTC) testing market, as more walk-in lab customers order at-home tests. Now, the US Food and Drug Administration (FDA) has authorized a DTC test company to provide results of a pharmacogenetic (PGx) test to customers without needing a doctor’s order. This is the first genetic test of its kind to receive such...

Balance Billing Under Increased Scrutiny at Both State and Federal Levels; Clinical Laboratory Tests Top List of Surprise Bills Received by Patients

Experts blame insurance regulators for not ensuring the adequacy of healthcare networks that include hospital-based physicians, such as pathologists and radiologists According to a recent study, clinical laboratories, anatomic pathologists, radiologists, and anesthesiologists top the list of providers who bill patients for the difference between what they charge for their services and a hospital’s contracted reimbursement rates. This so-called “balance-billing” not only causes hardship for...