News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

Hosted by Robert Michel

News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

Hosted by Robert Michel
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Nation’s Most Vulnerable Clinical Laboratories Fear Financial Failure If Medicare Officials Cut Part B Lab Fees Using PAMA Market Price Data Final Rule

As of January 1, CMS has begun accepting private payer market price data from certain medical laboratories required to report this information

Only 12 months remain before clinical laboratories in the United States face the ticking financial time bomb set to explode on January 1, 2018. That time bomb is the cuts to Medicare Part B clinical laboratory test fees that the federal Centers for Medicare and Medicaid Services (CMS) will implement on that date.

The Dark Report, Dark Daily’s sister publication, predicts that the Protecting Access to Medicare Act of 2014  (PAMA) private payer market price reporting final rule—if implemented by CMS as currently written—has the potential to be the single most financially disruptive event to hit the clinical laboratory industry during the past 25 years. At greatest risk are the nation’s smaller community laboratories and rural hospitals that rely on revenue from Medicare Part B lab testing to remain financially viable. (more…)

Forbes Tells the World How Medicare Bollixed Molecular Diagnostic Test Payments, Leaving Nation’s Clinical Laboratories Unpaid for Months

Columnist Steve Gottlieb, M.D., wrote that “This sort of bungling may be without precedent, even for the Medicare agency”

Since the beginning of the year, most Medicare contractors and private health insurers have not paid clinical laboratories and anatomic pathology practices for molecular diagnostic test claims coded to the 114 new molecular test CPT codes.

This unprecedented situation of labs going unpaid for more than three months has created financial turmoil and uncertainty across the medical laboratory profession. In fact, the question must be asked: Did Forbes columnist Scott Gottlieb, M.D., wake up the nation’s Medicare contractors with his column published on March 27? (more…)

Clinical Labs Make Money by Using Revenue Cycle Management

Management Tool Contributes to More Collected Revenue, Higher Sales Prices

Revenue Cycle Management (RCM) is hitting the radar screen at the nation’s best-managed clinical laboratories. That’s because shrinking reimbursement makes it imperative for clinical labs and pathology groups to collect every dollar legally due for the lab testing services they provide. RCM is a proven management tool for reducing unpaid claims and unlocking more productivity in the coding/billing/collections process.

“Revenue Cycle Management for laboratories encompasses all the administrative and management functions that contribute to the capture, and collection of revenue associated with lab testing services,” observed Lale White, CEO of Xifin, Inc. of San Diego, California. White has been an acknowledged national expert in laboratory coding, billing, and collections for more than two decades.