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UHC announces limitation for non-patient lab reimbursements

UHC announces limitation for non-patient lab reimbursements

by Alex Mitchell | Feb 14, 2020 | Revenue Cycle Management, Pathology Management

UnitedHealthcare has announced it will begin limiting reimbursements for hospitals acting as reference labs or conducting diagnostic testing on non-patients, according to a recent bulletin issued to providers. RELATED: Understanding and Navigating MUE and PTP Billing...
Identifying and preventing health care fraud

Identifying and preventing health care fraud

by Alex Mitchell | Feb 4, 2020 | Revenue Cycle Management, Pathology Management

Instances of health care fraud account for billions of dollars of lost revenue a year throughout the industry. Without the correct safeguards installed to help identify and end fraudulent practices, health care providers could face investigations and penalties that...
Aetna to end payments for PC of clinical pathology Aug. 1

Aetna to end payments for PC of clinical pathology Aug. 1

by Alex Mitchell | Jun 25, 2019 | Revenue Cycle Management, Pathology Management, Billing & CPT Codes

Aetna will no longer pay for the professional component of clinical pathology beginning Aug. 1. While the insurer initially ceased in-network payments for the professional component of clinical pathology services around 2005, many groups have remained out of network...
Dr. Emily Volk on seeking the office of CAP President-Elect

Dr. Emily Volk on seeking the office of CAP President-Elect

by Alex Mitchell | May 23, 2019 | Revenue Cycle Management, Pathology Management

During the past six years, Dr. Emily Volk, M.D., FCAP, has had the opportunity to travel the country and learn about the needs facing the profession of pathology while serving as an elected member of the Board of Governors for the College of American Pathologists...
Maximizing revenue under the BCBSM incentive program

Maximizing revenue under the BCBSM incentive program

by Alex Mitchell | May 15, 2018 | Revenue Cycle Management, Pathology Management

Did you know? Blue Cross Blue Shield of MI withholds 5 percent of all commercial payments. That means even if you’re earning 100% of the standard fee schedule, you’re still losing 5 percent!   Pathology value-based reimbursement For years, BCBSM has...
UHC announces limitation for non-patient lab reimbursements

Analyzing the overhauled 14-day molecular billing rule

by Alex Mitchell | Mar 12, 2018 | CMS Fee Schedules, Pathology Management

Under the old CMS 14-Day Rule, reference and independent laboratories were barred from billing Medicare directly for molecular pathology tests ordered less than 14 days after an outpatient was discharged from the hospital. Besides the obvious administrative challenges...
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