Improving Denial Management Through Artificial Intelligence
As CMS and private payors have increased the use of Medically Unlikely Edits and prior authorization programs over that past decade to control costs and utilization, providers and their billers have had to commit an increasing amount of time and resources to denial...
2023 Proposed Medicare PFS: See Impact to Pathology
The 2023 Medicare Physician Fee Schedule Proposed Rule was released late Thursday, July 7. After two consecutive years of a Congress delaying a number of anticipated reimbursement cuts due to the impact of the COVID pandemic, it now appears some of these previously...
How to Navigate MUE Denial Adjustments
By: Billie Mildenberger, Director of Audit Services, Lighthouse Lab Services RCM Case Study – MUE Denial Adjustments: Medically Unlikely Edits (MUEs) are used by Medicare Administrative Contractors (MACs), to reduce the improper payment rate for Part B claims....
What Makes a Good Lab RCM Partner?
Ask Ann is a new revenue cycle management mailbag headed by Ann Lambrix, Vice President of RCM Consulting for Lighthouse Lab Services. Each month, Ann will be tackling the burning billing and reimbursement questions from our clinical laboratory and pathology clients....