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...]
Hospital Laboratories Take a Stand Against Controversial UnitedHealthcare Outpatient Reimbursement Policy
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...]
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...]
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...]
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...]
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...]
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...]
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...]
Lab 2.0, The Future of Labs
What will the laboratory of the future look like? Attendees at G2's 36th annual Lab Institute (Oct. 24-26; Washington, D.C.) got a glimpse in the keynote "Transitioning from Lab 1.0 to Lab … [Read more...]