Aug 30, 2013 | Coding, Billing, and Collections, Compliance, Legal, and Malpractice, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Managed Care Contracts & Payer Reimbursement
Confusion, unhappiness, and many unresolved issues remain about the way government and private payers are handling claims for molecular diagnostic tests covered by the 114 new CPT codes Dust is settling from the fiasco triggered by the Medicare program’s failure to be ready on January 1, 2013, to settle molecular diagnostic test claims filed under the 114 new Tier 1 and Tier 2 molecular CPT codes. The damage is not just limited to Medicare test claims, but also involves private health plans...
Jun 21, 2013 | Coding, Billing, and Collections, Compliance, Legal, and Malpractice, Laboratory Management and Operations, Laboratory News, Laboratory Pathology
Medicare contractors are setting prices that are 40% to 60% lower than they paid medical laboratories last year for these same molecular diagnostic tests Non-payment for most new molecular diagnostic test CPT codes continues to be a problem for the majority of medical laboratories across the country. A lack of payment for these claims, have forced some clinical laboratories and pathology groups to stop doing molecular testing and lay off staff. At least one lab company shut its doors, blaming...
Jan 12, 2012 | Coding, Billing, and Collections, Compliance, Legal, and Malpractice, Laboratory Management and Operations, Laboratory News, Laboratory Pathology, Managed Care Contracts & Payer Reimbursement
Payors also are straining to handle new payment requirements under Form 5010, say intermediaries Across the nation, providers, including clinical laboratories and pathology groups, are holding their collective breath as they wait to see whether implementation of the electronic claim Form 5010 goes smoothly, becomes a disaster, or ends up somewhere between. Just two weeks into this national transition, experts are predicting that most providers—including medical labs and pathology groups—are...
Sep 23, 2010 | Laboratory Pathology, News From Dark Daily
Some U.S. laboratories already ramping up their LIS resources to meet demand for LIS-to-EMR interfaces Clinical laboratory managers and pathology groups need to prepare for what is expected to be a tsunami of requests by physicians who want their newly-implemented electronic medical record (EMR) systems to be interfaced with their laboratory’s LIS. This approaching tsunami is a consequence of the billions in federal incentive payments designed to encourage doctors to adopt EMRs. It means lab...
Oct 22, 2009 | Laboratory News, Laboratory Pathology
Labs Must Report Privacy Breaches of 500 or More to the Media Call it HITECH collides with HIPAA! Most pathologists and lab executives know that passage of the HITECH Act was the part of 2009’s American Recovery and Reinvestment Act (also referred to as “ARRA” or the “stimulus bill”). HITECH provides incentives for the expanded use of electronic health records by physicians and other providers. But what is lesser known is how the HITECH Act creates new legal obligations of covered entities and...
