Maximizing revenue under the BCBSM incentive program
Did you know? Blue Cross Blue Shield of MI withholds 5 percent of all commercial payments. That means even if you’re earning 100% of the standard fee schedule, you’re still losing 5 percent! Pathology value-based reimbursement For years, BCBSM has...
Analyzing the overhauled 14-day molecular billing rule
Under the old CMS 14-Day Rule, reference and independent laboratories were barred from billing Medicare directly for molecular pathology tests ordered less than 14 days after an outpatient was discharged from the hospital. Besides the obvious administrative challenges...
Lab prior-authorization programs continuing to evolve
With United Healthcare set to unveil a national prior-authorization process for genetic and molecular testing for fully insured members on Oct. 1, most major health plans are now utilizing some form of a laboratory benefits management (LBM) program in various parts of...What pathologists can expect from the 2018 Medicare Physician Fee Schedule
After significantly cutting the technical component for a number a key of pathology CPT codes last year, pathologists should be relieved to hear the vast majority of reimbursements levels are expected remain relatively unchanged next year, according to the proposed...