Medical Necessity: How Payers Turned Coverage Restrictions into the Moral High Ground
By: Jon Harol, Founder, LLS When did an insurer’s decision not to pay for a laboratory test become evidence that the test shouldn’t be performed? Over more than two decades working in the clinical laboratory industry, I have watched the concept of “medical necessity”... Medicare Fee Schedule Cuts Raise the Stakes for Revenue Cycle Performance
When reimbursement declines, protecting every earned dollar becomes a strategic priority. Healthcare providers continue to face increasing financial pressure as proposed Medicare payment changes threaten already narrow operating margins. Pathology practices and... What is MolDX and When Do I Need a Z-Code?
00:00 1X Laboratories performing infectious disease testing and billing Medicare Part B within a MolDX jurisdiction are subject to a new Local Coverage Determination (LCD) that stands to significantly impact reimbursement for these services. Labs in the... IHC Reimbursement Under the Microscope: What Pathology Groups Need to Know
00:00 1X Payment and coverage for immunohistochemistry (IHC) stains are facing increased scrutiny from both commercial and government payers. For pathology groups and laboratories, this heightened attention has translated into tighter policy language, expanded... 
Lighthouse Acquires MJB Lab Consulting, Expanding Medical Leadership Services