Unique Ways to Partner with Payers to Be Paid for Clinically-Necessary Tests: How to Avoid the Denial Loop

Webinar was held
Wednesday, October 11, 2017

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The current insurance reimbursement system for laboratory testing has significant issues, such as decision making that is too far removed from the patient, overprocessing (including dual systems of preauthorization), and tremendous variation between insurance companies regarding medical, administrative, and payment policies.

These and other problems lead to conflicts between insurers, health systems and patients. During this all-new webinar entitled “Unique Ways to Partner with Payers to Be Paid for Clinically-Necessary Tests: How to Avoid the Denial Loop,” held Wednesday, October 11, at 1PM EDT, attendees will get important updates about the current issues plaguing laboratory testing insurance reimbursement systems, and from an expert faculty, learn about specific collaborative strategies that provide potential solutions for your clinical lab.

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Here’s just some of what you’ll learn during this information-packed 90-minute session:

  • Develop win-win strategies for partnering with insurance companies to improve insurance reimbursement for medically-necessary tests
  • Make a laboratory stewardship program the foundation for cooperation with insurance companies
  • Incorporate key components into your stewardship program including expert case review of expensive send out tests, interventions to prevent duplicate orders, and procedures to improve results retrieval and interpretation
  • Learn from real-world examples of waste and inefficiency in the current system for laboratory claims reimbursement
  • How to outline a specific project to improve relations with at least one of your payers
  • Keys steps to setting the long-term goal of breaking the denial loop, by having insurance companies fast track your lab’s claims, and much more!

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Laboratory directors, pathologists, billing managers— you’ll want your entire staff to sit in on this webinar for the essentials to getting quick reimbursement, while at the same time providing the highest quality patient care and reducing the number of unnecessary tests.

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Speakers:

Michael Astion, M.D., Medical Director, Department of Laboratories, Seattle Children’s Hospital, Clinical Professor of Laboratory Medicine, University of Washington, Seattle, WA.

Dr. Astion is a clinical pathologist who is Medical Director, Department of Laboratories at Seattle Childrens Hospital and Clinical Professor of Laboratory Medicine at the University of Washington. For two decades he worked at the University of Washington where he was a Professor and Director of Reference Laboratory Services. His career is divided between clinical service, teaching, clinical service, and research and development.

He has authored more than 20 software titles, 40 peer-reviewed papers, and 40 editorials. His software includes both laboratory tutorials and competency assessment exams, and these materials are now used by more than 40,000 clinical laboratory workers annually in 1500 labs as part of the Medical Training Solutions laboratory training library. He is the editor-in-chief of Patient Safety Focus, which appears quarterly within AACCs Clinical Laboratory News.

Dr. Astion is currently working actively, through grants and intellectual property held by the University of Washington, with the insurance industry in the United States to create utilization management rules for clinical laboratory testing. In addition, he is one of the founders of PLUGS, the Pediatric Laboratory Utilization Guidance Service, a unique service that helps hospitals and clinics actively increase the value of lab testing for both adults and children.

Jessie H. Conta, Laboratory Genetic Counselor & Supervisor, SCH Department of Laboratories, Director of Genetic Counseling Services, PLUGS® Seattle Children’s Hospital, Seattle, WA.

Jessie Conta is a licensed genetic counselor in the Department of Laboratories at Seattle Children’s Hospital. She received her Masters of Science degree in genetic counseling from Brandeis University in 2004.

Conta provided clinical genetic counseling services for many years before she transitioned to the laboratory, most recently working as a pediatric genetic counselor in the Division of Genetic Medicine at Seattle Children’s Hospital.

In her current role as a laboratory genetic counselor and supervisor, she provides pre- and post-analytic support to the genetics subspecialty labs at Seattle Children’s Hospital and is part of the consulting team that reviews and approves requests for send-out genetic tests. She is also involved in developing best practice recommendations related to genetic testing, including appropriate pre-test evaluations, sequential testing strategies, pre- and post-test counseling, and insurance pre-authorization for genetic tests. Jessie is a co-founder of Pediatric Laboratory Utilization Guidance Services (PLUGS), a national collaboration of institutions working on test utilization management strategies to improve the value of testing for patients, families, and providers.