Blog Posts by Tag: Molecular
Overcoming Reimbursement Compression: The Latest Trends in Denials for Laboratories and Pathology Practices
This is the second article in a three-part series on denial and appeals trends. This article focuses on claim denial trends by payor group and by market segment, and denial trends for claims with a 2021 date of service differ from a similar analysis completed on claims with dates of service in 2018. If you missed the first article in this series on the importance of physician engagement in...
Denials and Appeals Management: The Importance of Patient Engagement
Revenue cycle management (RCM) for laboratories and pathology practices is constantly evolving in complexity. Payors introduce new and more rigid policies that make collecting reimbursement for services rendered increasingly difficult. XiFin recently published a new whitepaper, Overcoming Reimbursement Compression: The Latest Trends in Denials and Appeals Management for Laboratories and...
Avoiding LIS Disruptions: Applying Lessons Learned from Southwest Airlines
This blog expands on the impact related to a recent blog, "What Can Medical Providers Learn from the Southwest Airlines Fiasco." If you missed that blog, we encourage you to read it. In healthcare, especially laboratory testing, a significant percentage of medical decisions are based on test results. Laboratory test results influence approximately 70% of medical decisions that are made by...
Automation Strategies for Molecular Diagnostic Market-Share Expansion
This blog post is the third in our series covering the keys to success for market-share expansion in molecular diagnostics based on our recently published whitepaper, “The Executive’s Guide to Molecular Diagnostic Market-Share Expansion”. If you missed either of the first two posts in this series, you can find the first post, “Molecular Diagnostic Market-Share Expansion: Keys to Success” here and...
Tired of Hidden Charges from Your LIS Vendor?
One of the most common complaints from laboratory executives is hidden charges that they face from their LIS providers. In our recent LIS State of the Industry Survey, a common theme among respondents was the cost of their LIS and the unpredictable charges they often face.Laboratory leaders routinely see unexpected charges for: Hardware/server upgrades Operating system upgrades Security...
The Importance of Physician and Patient Engagement for Molecular Diagnostic Market-Share Expansion
This blog is the second in our series covering the keys to success for market-share expansion in molecular diagnostics outlined in our recent whitepaper, “The Executive’s Guide to Molecular Diagnostic Market-Share Expansion”. We encourage you to read Part 1 and Part 3.As more molecular diagnostic testing moves from physician offices and laboratories to the home, molecular diagnostics...
Optum’s Laboratory Benefit Manager Program: Focus on CPT 81479
In 2022, Optum launched its new laboratory benefit management (LBM) program to help health plans reduce unnecessary lab testing through automated payment denial. The LBM program leverages Avalon Healthcare Solutions, which has developed evidence-based lab policies with automated software tools, and the MolDX program, which identifies and establishes Medicare coverage and reimbursement for...
Molecular Diagnostic Market-Share Expansion: Keys to Success
This blog is part of a series. We encourage you to read Part 2 here and Part 3. The molecular diagnostics market has experienced tremendous growth in recent years. It’s a complex business with many challenges, including prior authorization requirements, diagnostic coding changes, the evolving regulatory landscape, and specimen collection moving from physician offices and laboratories to the home...
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