Effectively Navigating Medicare TPE Audits for Clinical Labs
Medicare’s Targeted Probe and Educate (TPE) program is designed to identify and reduce improper payments, enhance compliance, and educate providers on proper billing practices. While TPE audits are intended to be educational rather than punitive, receiving an...
How to Navigate MUE Denial Adjustments
By: Billie Mildenberger, Director of Audit Services, Lighthouse Lab Services RCM Case Study – MUE Denial Adjustments: Medically Unlikely Edits (MUEs) are used by Medicare Administrative Contractors (MACs), to reduce the improper payment rate for Part B claims....
Navigating Medical Necessity for PCR Testing
It’s essential for referring providers considering large panel tests to grasp the nuances of Medicare National Coverage Determinations (NCDs) and Local Coverage Determinations (LCDs) in order to effectively navigate medical documentation requirements. Without...
How Labs Should Respond to the Change Healthcare Cyberattack
In the wake of the recent Change Healthcare cyberattack, independent lab owners and pathology groups are facing critical challenges. This overview aims to address common questions and concerns related to the attack’s impact on revenue cycles, compliance, and patient...
Lighthouse Acquires MJB Lab Consulting, Expanding Medical Leadership Services