Reimbursement

CMS Mulls Automatic Medicare Coverage of MCIT Breakthrough Devices

Manufacturers of innovative medical devices are on pins and needles right now. That is because the Centers for Medicare and Medicaid Services (CMS) delayed implementation of a final rule that was … [Read more...]

The Business of Testing

Hospital Laboratories Take a Stand Against Controversial UnitedHealthcare Outpatient Reimbursement Policy

The cold war between hospital laboratories and the nation’s third largest health insurer, UnitedHealthcare (UHC), over reimbursement of diagnostic tests is getting hotter by the day. At the center of … [Read more...]

Top of the News

Major Insurer Claims It Has No Obligation to Pay for Pooled COVID-19 Testing

Free COVID-19 testing is a powerful and very compelling policy. The problem, of course, is that somebody has to pay for coronavirus testing. And the insurance companies have been designated as that … [Read more...]

Reimbursement

Payors Gradually Increasing Coverage of Liquid Biopsies but Obstacles Remain

Gaining the acceptance of insurers and payors for new tests and testing technology is a perennial challenge for laboratories and test developers. This has been especially true with liquid biopsy … [Read more...]

The Business of Testing

New COVID-19 Revenues Not Enough to Offset Declines in Elective & Screening Tests

That line from Charles Dickens’ A Tale of Two Cities about the best of times and the worst of times is especially apt with what testing laboratories in the US and around the world are experiencing. … [Read more...]

Coronavirus

CMS Develops Additional Code for Coronavirus Lab Tests 

On March 6, the Centers for Medicare & Medicaid Services (CMS) announced a  second Healthcare Common Procedure Coding System (HCPCS) code that can be used by laboratories to bill for certain … [Read more...]

Genetic Testing: Proposed New Medicare Coverage Rules for NGS Germline Testing of Early-Stage Cancer Patients

Medicare coverage of germline next-generation sequencing (NGS) panels for early-stage cancer patient has been a topic of controversy of late. The problem began when the Centers for Medicare and … [Read more...]

CO-ORDINATING DATA

Laboratory Information Systems (LIS): What You Need To Know To Get Paid

By Sean McSweeney  bio Today, laboratory billing claims require more and more data to successfully get paid. One of the biggest reasons your claims may be getting denied is because you're not … [Read more...]

PAYER CONTRACTS

Three key items to negotiate for successful payer contracts

By Steve Selbst  bio The purpose of this article is to help you, as a provider, to focus on three key items to look for in payer contracts that will help you to get profitable contracts in … [Read more...]

THE BUSINESS OF TESTING

Payer Medical Policies Can Promote Effective Use of Comprehensive Sequencing In Community Oncology Setting

Comprehensive genomic profiling (CGP) identifies clinically relevant genomic alterations that can be used to inform treatment decisions in community-based oncology practices that benefit both patients … [Read more...]


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