Case Study: Payer Denying Lab Outreach Work Due to Policy Error
By: Beth Madden, Client Manager, Lighthouse RCM Solutions The Issue Our RCM Solutions Team often digs into denials that continually stem from the same payer in order to help our clients better understand what is creating a payment logjam while ensuring future claims...
The importance of TC Modifiers in Pathology Professional Component Billing
By: Dyana Williams, RCM Client Engagement Manager As we continue to optimize our clients’ billing practices, it is crucial to ensure they have a clear understanding of the use of the TC (Technical Component) modifier, especially in situations where a pathology group...
The Power of Front-End Billing Edits: A Comparative Analysis of Claim Denials
By: Dyana Williams, Client Engagement Manager Understanding and addressing claim denial reasons is crucial for the financial stability of medical and pathology laboratories. As part of a recent case study, our RCM Solutions Team delved into the denial patterns of two...
CMS Targeting Errors on Drug Testing Claims Following TPE Review
Last year, we notified drug testing providers CMS was reviewing definitive and presumptive drug screening claims for errors and missing documentation as part of its Targeted Probe and Educate (TPE) program. Results for the WPS Region were published last week, showing...