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BCBS Alabama Conducting Lab Overpayment Reviews

BCBS Alabama Conducting Lab Overpayment Reviews

by lighthouselab | Oct 27, 2022 | Revenue Cycle Management, Industry Insights, Clinical Laboratory

Lighthouse’s RCM Solutions Team was recently made aware that Blue Cross Blue Shield of Alabama is conducting overpayment reviews for infectious disease testing that could result in takebacks for impacted clinical laboratories. The message (available below)...
Labs, Pathologists Aim to Delay 2023 Medicare Fee Schedule Cuts

Labs, Pathologists Aim to Delay 2023 Medicare Fee Schedule Cuts

by Alex Mitchell | Oct 12, 2022 | Revenue Cycle Management, Industry Insights, Clinical Laboratory

As clinical laboratories and pathology groups prepare to operate outside of the Covid Public Health Emergency for the first time in years, many are turning an eye toward Medicare fee schedule cuts that could be reinstated after years of delays. According to Ann...
How SALSA Would Create a Sustainable Clinical Lab Fee Schedule

How SALSA Would Create a Sustainable Clinical Lab Fee Schedule

by Alex Mitchell | Aug 25, 2022 | Revenue Cycle Management, Industry Insights

Although clinical laboratories have experienced drastic Medicare rate reductions since the introduction of the Protecting Access to Medicare Act (PAMA) required them to begin reporting private payer data to Medicare in 2017, several pandemic-related delays in recent...
MIPS 2023: Reporting for Pathologists

MIPS 2023: Reporting for Pathologists

by Alex Mitchell | Aug 9, 2022 | Pathology Management, Revenue Cycle Management

By: Beth Madden, Client Administrator CMS has announced what lies ahead for the Merit-based Incentive Payment System (MIPS) program with proposed adjustments for the 2023 performance year, which impacts Medicare Part B payments in 2025. RELATED: 2023 Medicare...
Improving Denial Management Through Artificial Intelligence

Improving Denial Management Through Artificial Intelligence

by Alex Mitchell | Aug 8, 2022 | Revenue Cycle Management, Industry Insights

As CMS and private payors have increased the use of Medically Unlikely Edits and prior authorization programs over that past decade to control costs and utilization, providers and their billers have had to commit an increasing amount of time and resources to denial...
2023 Proposed Medicare PFS: See Impact to Pathology

2023 Proposed Medicare PFS: See Impact to Pathology

by Alex Mitchell | Jul 11, 2022 | Revenue Cycle Management, CMS Fee Schedules

The 2023 Medicare Physician Fee Schedule Proposed Rule was released late Thursday, July 7. After two consecutive years of a Congress delaying a number of anticipated reimbursement cuts due to the impact of the COVID pandemic, it now appears some of these previously...
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