Blog Posts by Date: Jul 2020


G0416 Prostate Update for Cigna: Go-Live August 18, 2020

As announced by Cigna earlier this summer, beginning August 18, 2020 Cigna will require pathology groups to submit G0416 for prostate needle biopsies instead of 88305. Prostate biopsies will no longer be reimbursed using the 88305.XIFIN confirmed with Cigna that this applies to all Cigna plans, not just a select few. Commercial payors aligning...

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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...

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Learn from the Q&A with Leaders from MercyOne Des Moines Laboratory

We recently had the pleasure of speaking with Mona Dinnauer and Teri Reiff from MercyOne Des Moines. Mona Dinnauer, MHA, MLS (ASCP)CM is the director of outreach services, and Teri Reiff, MHA, MLS (ASCP)CM is the market director for laboratory services at MercyOne Des Moines. Below is a summary of some of the key questions they addressed...

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Florida Society of Pathology Pushes to Retain PCCL Reimbursement from Medicaid

Florida Society of Pathology (FSP) held a call for members on July 15th to review the process the organization had taken upon learning the state’s Medicaid plan would no longer fund Professional Component of Clinical Laboratory (PCCL) reimbursement. Florida is among less than a handful of states, including California and Illinois, that sill...

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How Upcoming Changes to United Health’s Laboratory Test Registry May Impact Your Lab

Important Update:In response to the COVID-19 Public Health Emergency (PHE), UHC has made a decision to delay the implementation of the Laboratory Test Registry Protocol to January 1, 2021.  A UHC representative informed XIFIN in a July 17, 2020 correspondence, “To ensure compliance with these requirements, free-standing and outpatient...

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Time Is Running Out to Voice Concern over the SPA 20-0010 Amendment

Important: Public input on this controversial amendment must reach the DHCS no later than Monday, July 27, 2020, to guarantee consideration before SPA 20-0010 is submitted. See various ways to contact the DHCS at the end of this article. The Department of Health Care Services (DHCS) plans to submit its State Planned Amendment (SPA) 20-0010 to the...

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Insurers Not Required to Reimburse COVID-19 Tests for Returning Workers

According to newly released guidelines from the Trump Administration, insurers will not have to cover COVID-19 screening tests mandated by employers for returning employees.Until these new guidelines, The Families First Coronavirus Response Act required insurers to cover COVID-19 testing without patient cost-sharing. The latest announcement said...

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Using EHRs or Enterprise Systems for Revenue Cycle Management of Ancillary and Ambulatory Services? Your Revenue is Being Negatively Impacted

Electronic health record (EHR), enterprise systems, and other practice management software fail to support the unique RCM needs of ancillary and ambulatory services. Lacking the appropriate RCM tools and solutions prohibits these valuable services from having visibility into their RCM processes and being fully reimbursed for the services they...

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