Why Revenue Cycle Management Systems Fall Behind—and How to Modernize Them
Clinical lab billing teams face an overwhelming number of challenges if revenue cycle strategies fall short
Clinical lab billing teams face an overwhelming number of challenges if revenue cycle strategies fall short
CMS has instructed its MACs to recognize eight new CLIA-waived complexity tests for which labs will be allowed to bill, effective Oct. 1.
As of August 31, 2022, labs and other providers must use the new ABN labeled with the appropriate federal OMB Number (0938-0566) and CMS-R-131 to ensure they can bill Medicare beneficiaries for any lab tests or other services that Medicare doesn’t cover.
According to a recent OIG report, CMS is not doing a good job collecting the Medicare overpayments OIG auditors are uncovering. However, CMS recently rejected almost all of the recommendations in that report, suggesting all is not well between the two federal agencies.
The new report could be a turning point in the battle to curb payor abuse of preauthorization requirements.
Here are the two key CLFS changes, set to take effect on July 1, 2022, that your billing staff needs to know about.
Here’s a look at the key takeaways from the Dec. 30 OIG report on Medicare Part B spending on lab testing.