Case Study: Using Billing Data to Bolster Lab Contract Negotiations
Overview A leading laboratory client was initially offered a reimbursement rate of 100% Medicare for their commercial policies. Given that commercial payors typically reimburse significantly higher than Medicare rates, accepting this offer would have left substantial... How Pathology Groups and Labs Can Advocate for Better Compensation
Pathology and laboratory services are vital to clinical decision-making, from routine diagnostic testing to guiding complex cancer care. Yet, these professionals increasingly feel the squeeze from declining reimbursements and rising operational costs. For both... What’s Standard for Medical Lab Billing Contracts?
Entering into an agreement for medical billing services is an important process for any clinical lab or pathology group that does not have this service provided by a hospital or other partner. But what metrics and capabilities should a medical group or lab look for... Is My Lab Required to Report PAMA Data?
Originally put into effect in 2017, the Protecting Access to Medicare Act (PAMA) requires many labs to report private payer data for clinical diagnostic lab tests to CMS every three years. The data is used to determine median payments in an effort to bring the... 