New Novitas Process Set to Impact Pathology and Laboratory Claims
By: Billie Mildenberger, Director of Audit Services Note: Novitas announced this change will not take effect until Sept. 19, 2024. Starting Aug. 18th, 2024, Novitas will implement a process impacting newly effective molecular pathology and Proprietary Lab Analysis...
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....
7 New Payer Contracts Obtained for Full-Service Medical Lab
Overview The client is an independent medical laboratory located in the Southeast of the U.S. that has served its local community for almost seven years. It is a full-service lab including blood culture, toxicology, and molecular testing. RELATED CASE STUDY: Expanding...
Lighthouse Acquires MJB Lab Consulting, Expanding Medical Leadership Services