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Blog Posts by Tag: Pama

The Ugly Truth About Payors and PAMA

Recently CAP Today provided an excellent recap of XIFIN CEO and Executive Chairman, Lâle White's Executive War College presentation "Ugly Truth about Payors & PAMA: What Labs Can Expect and How to Respond." In this blog post, we break down some of the key points: PAMA Is a Price Reduction ProgramContrary to its publicized goal of achieving market-based pricing, the government...

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XIFIN RPM Helps Lab Outreach Business Grow Collections by 15%

Mona Dinnauer is the Laboratory Director, Outreach Services, at MercyOne Des Moines Laboratory, which is part of Des Moines Medical Center. The facility was founded in 1893 and is the longest continually operating hospital in Des Moines, Iowa, and is a member of the MercyOne network, a collaboration of CommonSpirit Health and Trinity Health.The laboratory's full-service outreach business started...

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Insights on the Current State of the Laboratory Industry

Today’s laboratory environment is constantly changing in some way or another, and those who wish to stay relevant and succeed must embrace digital transformation and stay on top of new rules and regulations. At XIFIN, we recognize that laboratories can often be overlooked in the wide scope of healthcare and understand the importance of engaging with our customers and partners. By pooling our...

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ACLA Wins in Appeals Court Versus HHS

Recently, the DC Court of Appeals determined that federal courts do in fact “have jurisdiction to decide the merits of a challenge to the federal government’s administration of the Protecting Access to Medicare Act (PAMA).”1 This ruling will result in the ACLA vs. Azar case being sent back to the DC District Court to determine if the decision from HHS/CMS to exclude hospital outreach labs from...

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ACLA Issued a Statement to CMS on Automated Chemistry Test Panels

After claims from the Government Accountability Office (GAO) in November of 2018 that labs unbundling automated chemistry test claims will correlate to a drastic increase in Medicare spending, many industry thought leaders are responding. Most recently, ACLA has released a statement claiming that GAO’s assumptions are not backed by Medicare’s public claims data, or by ACLA’s own survey conducted...

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The 5 Keys to Minimizing the Impact of PAMA

At this year's Executive War College Conference, XIFIN CEO and Executive Chairman, Lâle White presented on PAMA’s effects on laboratories and gave some thought-provoking ideas on how labs can respond. This blog post will cover many of the topics that Lâle discussed, starting with this timeline of industry events which provides background on the laboratory reimbursement environment...

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How the Most Successful Laboratories in the Country Continue to Thrive in the Midst of an Increasingly Complex Reimbursement Environment

The business of laboratory revenue cycle management (RCM) becomes more complex every day; with reductions in reimbursement, increasing rejections and denials, payor specific billing rules, shifting financial reporting and accounting requirements (PAMA, FASB ASC 606, medical economics reporting), OIG and EKRA (false claims) compliance standards, malware and ransomware attacks, etc. Once there was...

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Final Steps in Preparing for the PAMA Reporting Period (Part 2)

In our last post of this series, we identified “The First Steps in Preparing for the PAMA Reporting Period” as confirming your laboratory’s applicable lab status, executing an RCM data review, and assigning a project team and project team lead. Once you have carried out these steps, there are four additional steps to be taken before you complete your submission.  Step 4:...

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