Balancing Compliance, Risk, and Revenue in Toxicology Testing
00:00 1X For many labs, toxicology has long been a top target for payer audits. Reimbursement cuts and stricter “medical necessity” interpretations are raising denials, claw-backs, and scrutiny, especially around frequency of testing and documentation quality....
Expanding Molecular PCR Services by Securing Nationwide Payer Contracts
Client: Infinite Genomics, LLC Overview Infinite Genomics was formed as a molecular diagnostic laboratory in 2021. Although the lab is located in North Little Rock Arkansas, it intended to offer PCR services to providers across the nation. To put that plan...
Understanding and Navigating Medicare MUE, PTP Edits
The Medicare National Correct Coding Initiative (NCCI) (also known as CCI) was installed to promote national correct coding methodologies and to control improper coding leading to payment. NCCI Procedure-to-Procedure (PTP) code pair edits are automated prepayment...
Medical Billing Audit Unlocks $20K in Claims After Cyberattack
00:00 1X As we look back at recent trends, 2024 may go down as the year of the cyberattack. In February of last year, the Change Healthcare breach made national headlines as the largest healthcare cyberattack in history, halting claims submission and disrupting...
