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...
The importance of TC Modifiers in Pathology Professional Component Billing
By: Dyana Williams, RCM Client Engagement Manager As we continue to optimize our clients’ billing practices, it is crucial to ensure they have a clear understanding of the use of the TC (Technical Component) modifier, especially in situations where a pathology group...
The Power of Front-End Billing Edits: A Comparative Analysis of Claim Denials
By: Dyana Williams, Client Engagement Manager Understanding and addressing claim denial reasons is crucial for the financial stability of medical and pathology laboratories. As part of a recent case study, our RCM Solutions Team delved into the denial patterns of two...
Using Billing Data to Compare Commercial Lab Reimbursements
By: Dyana Williams, Client Engagement Manager, Lighthouse RCM Solutions Recently, a Lighthouse RCM Solutions client asked their billing vendor: What is our commercial reimbursement rate as a percentage of Medicare for CPT 88305? Utilizing our RCM Spotlight billing and...