Jun 10, 2013 | Coding, Billing, and Collections, Laboratory Management and Operations, Laboratory News, Laboratory Pathology, Uncategorized
A newspaper in San Francisco featured a story about the patient’s complaint about being overcharged thousands of dollars by the hospital for medical laboratory tests
Here’s how a community hospital that charges inpatient prices for clinical laboratory testing to a walk-up customer find itself at the center of a media news storm. In California, a newspaper trumpeted the story of an unhappy consumer stuck with a $4,316.55 bill for a panel of medical lab tests that a national lab would have performed for just $464, about 90% cheaper!
Cautionary Tale for Medical Laboratories and Pathology Groups
Price transparency is a major trend in healthcare and consumers are catching on quickly. This raises the stakes for any hospital, medical laboratory, and anatomic pathology group that is slow to respond to the growing number of consumers who now price-shop whenever they need clinical laboratory tests. (more…)
Mar 4, 2013 | Compliance, Legal, and Malpractice, Laboratory News, Laboratory Operations, Laboratory Pathology, Management & Operations
Steep increases in insurance costs may leave patients with less money to cover deductibles and copayments for clinical laboratory tests
Next year, consumers and small businesses can expect what one health insurance CEO says will be, “Premium rate shock for 2014.” As this happens, clinical laboratories and pathology groups are likely to find it even more difficult to collect co-pays, deductibles, and out-of-pocket fees from patients who had medical laboratory tests performed.
The premium rate shock remark was made by no less than Mark Bertolini, the CEO of Aetna, Inc. (NYSE: AET). In his speech at an investor conference, he predicted premiums would rise by 20% to 50% next year before the government subsidies are applied. In some markets, rates could double, he added.
Aetna is not alone in seeking steep hikes in health insurance premiums. Blue Shield of California is seeking a rate increase of 12% to 20% for more than 300,000 individuals, The Los Angeles Times reported. These new rates would go into effect in March, the company said. (more…)
Jun 29, 2012 | Coding, Billing, and Collections, Compliance, Legal, and Malpractice, Digital Pathology, Instruments & Equipment, Laboratory Hiring & Human Resources, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Laboratory Sales and Marketing, Management & Operations
Price transparency expected to encourage competition among healthcare providers, including medical laboratories
Before consumers visit a clinical laboratory, they can now check the “fair” price of medical laboratory tests. New websites have sprung up that make it easy for consumers to find what experts consider to be fair market prices for each type of lab test, as well as for other medical procedures and healthcare services.
Pathologists should think of the well-known “Kelly Blue Book” that has been the price authority for prices of new and used automobiles for decades. These new medical price websites are easy to use and make it quick for a consumer to find “fair” prices for common clinical laboratory test and medical procedure.
These new web-based companies are organized to serve the needs of consumers who are enrolled in high-deductible health plans (HDHP). For an individual, an annual deductible can be as high as $2,500—and as much as $5,000 for a family. Thus, clinical laboratory managers should not be surprised that consumers are actively price-shopping before they visit their laboratory to have a specimen collected.
(more…)
Nov 14, 2011 | Compliance, Legal, and Malpractice, Laboratory News, Laboratory Pathology, Laboratory Sales and Marketing
Two Senate committees seem interested in how certain medical laboratories offer discounted laboratory test prices to selected health insurers
Is it a coincidence that discounted medical laboratory test pricing offered by the nation’s two largest clinical laboratory companies appears to now be the subject of interest for the Senate Judiciary and Senate Finance Committees? Last Tuesday, Senator Max Baucus (D-Montana) and Senator Chuck Grassley (R-Iowa) issued a press release titled “Grassley, Baucus Scrutinize Practice by Health Insurers and Testing Labs.”
Baucus is Chairman of the Senate Finance Committee and Grassley is the Ranking Member of the Senate Judiciary Committee. Together, these two Senators sent letters last week to two clinical laboratory companies and three big health insurance firms: (more…)
Oct 28, 2011 | Coding, Billing, and Collections, Laboratory News, Laboratory Pathology
Data represents $1 trillion in spending since 2000 and contains clinical laboratory and pathology data
In what may turn out to be a positive development for clinical laboratories and pathology group practices, four of the nation’s five biggest health insurance companies will collaborate and put their medical claims data for billions of transactions into a single data base. Researchers say this database will give them an unprecedented ability to assess utilization trends and the clinical care delivered to patients covered by private health insurance.
The four health insurance companies that will provide data are:
The data provided by each of these health insurers will be submitted to the newly-created Health Care Cost Institute (HCCI). This data will consist of more than five billion medical claims dating back to 2000. These claims represent more than $1 trillion in spending. The health insurers are also providing the financing required to launch HCCI. (more…)
