With ongoing COVID-driven disruptions, 2021 was yet another challenging year for the healthcare industry. XIFIN's Beyond Billing blog kept pace, addressing key issues and hot topics. Here are the top blogs of 2021.
1. UHC Announces Designated Diagnostic Provider Requirements for Coverage
When UHC announced plans to implement the Designated Diagnostic Provider benefit designs beginning July 1, 2021, only pathology groups and laboratories (hospital-based and independent labs) would be impacted. But, beginning in 2022, the Designated Diagnostic Provider requirements will expand to include major radiology services.
Outpatient laboratory services are covered for fully insured commercial plan members only if delivered by a lab Designated Diagnostic Provider.
Read the full blog post to learn more about the quality and efficiency requirements for participation.Read Now
2. UHC Implements DEX Z-Code Requirements on Medicare Advantage Claims Starting June 1, 2021
In March 2021, UHC announced an updated policy for Medicare Advantage plans that require providers to include the appropriate DEX Z-Code identifier on claims. After delays in the implementation, this requirement became effective on October 1, 2021.
For information on how providers can register their test for a DEX Z test code or how to access and obtain a DEX Z-Code identifier, check out the blog.Read Now
3. XIFIN Announces East Coast Expansion to Charleston – Join Our Growing Team!
In August 2021, we opened the doors of our second facility in Charleston, South Carolina. As XIFIN is headquartered in San Diego, California, the decision to open an east coast office is fueled by our commitment to support and meet the needs of hospital-based and independent clinical laboratories and pathology services customers nationwide.
Since our expansion, the XIFIN family has grown immensely, with plans to open over 150 positions within the next two years.
Read more about our expansion and visit our careers page to view all open positions and apply.Read Now
4. 2022 PAMA Reporting Requirements and Reimbursement Cuts Will Impact Hospital and Independent Labs
PAMA reporting requirements and reimbursement cuts impacting hospital and independent laboratories have been delayed to 2023.
The next data reporting period of January 1, 2023, through March 31, 2023, will be based on the original data collection period of January 1, 2019, through June 30, 2019. For 2022, there was a 0% payment reduction in the clinical lab fee schedule. While hospital-based outreach laboratories were impacted by the 10% CLFS cut between 2019 and 2020, the flawed definition of an applicable laboratory in the original legislation excluded most hospital laboratories from the 2017 round one data reporting requirement. Under the updated definition of an applicable laboratory, established in 2019, most hospital-based outreach laboratories will be required to report.
Read more about PAMA Reporting Requirements on our blog and stay in the know by visiting our PAMA Headquarters.Read Now
5. Addressing EKRA Sales Force Compensation Mandates to Improve Both Compliance and Profitability
XIFIN Executive Chairman and CEO, Lâle White, discusses how the emergence of COVID-19 has contributed to the discovery of EKRA's much wider impact.
As part of the SUPPORT Act, the Eliminating Kickbacks in Recovery Act (EKRA) was passed in October 2018, with the intention to battle the opioid crisis. In addition, the Department of Justice is looking to utilize EKRA to fight fraud and prohibit remuneration for referrals.
How is being EKRA compliant beneficial for laboratories? And how can XIFIN Advanced Analytics help?
Read the full blog post to learn more.Read Now