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Blog Posts by Tag: Prior Authorization

Connecting and Automating Diagnostic Revenue Cycle Management: Eligibility Verification Speeds Reimbursement, Drives Revenue, and Reduces Operating Cost

When laboratories and other diagnostic providers use multiple disconnected systems to manage the complexity of diagnostic claim billing and revenue cycle management (RCM), this often leads to errors, rework, and other inefficiencies, ultimately driving higher operating costs. Diagnostic providers sometimes attempt to connect or “bolt-on” supplemental capabilities to augment missing or subpar RCM...

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Automation of Prior Authorizations and Appeals is Possible and Key to Reducing Costs

Many issues are challenging diagnostic providers’ ability to maximize payor reimbursements, such as the significant increase in required prior authorizations (PAs) and the high cost of appeals.These issues are even more difficult for laboratories and remote patient monitoring device companies using traditional billing systems that have few or no automation tools. Hospital outreach programs and...

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UHC Suspends Prior Auth Requirements for Trichomonas & Candida, Will Adopt CMS Billing Policy for Prostates on January 1, 2021

Suspension of Trichomonas and Candida Prior Auth Requirements Beginning Oct. 1, 2020, for all commercial and UnitedHealthcare Community Plan plans included in the genetic and molecular testing program, UHC will be suspending prior authorization and notification requirements for the following three genetic and molecular CPT codes performed in an outpatient setting: 87480: Infectious agent...

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Effective Billing Strategies to Drive Growth and Value While Decreasing Total Cost of Billing for IDTFs (Part 2 of 4)

Jessica SubletteDirector of Revenue Cycle, XIFIN Marissa GeracheSenior Customer Service & Account Manager of MDx, XIFIN As we explored in part 1 of this 4-part series, many companies in the independent diagnostic testing facilities (IDFT) business fail to recognize just how important and...

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Selecting a Purpose-Built Lab RCM and Service Is the Right First Step ― But They’re Not All Equal

Over the past year, leading global IT research and advisory firm, International Data Corporation (IDC) published a paper and participated in a webinar discussing the benefits for hospitals and health system laboratories in choosing purpose-built revenue cycle management (RCM) systems. In the IDC paper, research director Mutaz Shegewi examines the specific benefits for hospitals and health systems...

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Hottest Blog Topics of 2019

In 2019 we discussed many thought-provoking topics and trends regarding laboratories, medical billing, revenue cycle management, and much more. Here is a short recap of the top 5 most-influential blog posts:1. Hidden Landmines in Revenue Cycle Management: Industry Challenges, Patient Engagement, and Denial TrendsMany trends in payor behaviors and reimbursement go unnoticed due to outdated RCM...

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3 Steps to Ease the Prior Authorization Burden

Enjoy the following content from our partner, Infinx. It’s no secret that prior authorization (PA) requirements create a time-intensive burden that delays patient care and takes providers and staff away from their clinical activities only to spend that time with administrative tasks and redundant paperwork. The American Hospital Association (AHA) reported that...

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Accurate Patient Responsibility Estimates Dramatically Improve the Patient Experience

Customer experience is one of the most significant long-term differentiators in healthcare and diagnostics, as it is in virtually all other sectors. There is a direct correlation between customer experience and engagement, and consumers have been trained to expect more when it comes to service and experience by companies such as Amazon, Apple, and Southwest Airlines. A survey of 1,000 patients...

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