Don’t Overlook Free Resources When Preparing Your Laboratory for ICD-10

The transition to ICD-10 is approaching fast and laboratories need to ensure they are prepared. While the Centers for Medicare and Medicaid Services (CMS) has indicated in answers to Frequently Asked … [Read more...]

The Art of Appeals: Don't Give Up Too quickly When a Payer Denies Your Claim

In the first part of this two-part series, we told you how to reduce the chances that payers would deny your claims. This month, you'll learn what you can do when, despite your best efforts, they … [Read more...]

Get Paid With Less Stress

Occasional denials from payers are just part of doing business for health care providers. But labs face challenges getting paid that clinicians don’t. In this two-part series, you’ll learn how to keep … [Read more...]

Ensure Regular training for Billing and Coding staff

Don’t overlook continual training of your billing and coding staff. It’s a compliance principle that the OIG emphasized in its initial compliance guidance for laboratories in 1998 and it is still just … [Read more...]

Whistleblowers Can Offer Statistical Sampling to Support Fraud Claims

A federal trial court in Florida has ruled that qui tam or whistleblower plaintiffs can use statistical sampling to prove fraud in a False Claims Act lawsuit. The court explained:“[N]o universal ban … [Read more...]

Stark and Anti-Kickback Issues Expected to Increase for Laboratories in 2015

Health care experts and attorneys predict 2015 will be a significant year for Health and Human Services Office of Inspector General (OIG) investigations of physician self-referral (Stark) and … [Read more...]

Device Maker Pays $2.8 Million to Settle False Claims Allegations

Even though Medtronic Inc. does not bill Medicare, the Department of Justice (DOJ) alleges it caused others to submit claims based on coding and billing information it provided for a procedure that … [Read more...]

Upcoming Conferences

Molecular Coding and Billing Workshop How to Get the Right Payment in 2013 Jan. 24, 2013 Westin Atlanta Airport Atlanta Volume to Value Redefining Lab Services … [Read more...]

G2 Compliance Perspectives: Preparing for 2013: Molecular Pathology Codes Represent Dominant Path and Lab CPT Changes

The budgetary and policy climate will greatly impact laboratories in 2013. With the increased growth shift toward the adoption of accountable care organizations (ACOs), as well as bundled … [Read more...]

Strategies for Assessing the Effectiveness Of Your Lab Compliance Program

Despite ongoing reports of clinical laboratories that have had enforcement actions brought against them as a result of a weak or faulty compliance program, many labs fail to routinely measure the … [Read more...]