United Healthcare Reimbursement Policy Update for Molecular Pathology

United Healthcare announced that the effective date of their reimbursement policy update for molecular pathology has moved from dates of service beginning September 1, 2019, to dates of service beginning November 1, 2019.This reimbursement policy change affects claims submitted with codes for Tier 1 and Tier 2 Molecular Pathology. Tier 2 Molecular Pathology codes are 81400 – 81408, and are to be...

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Understanding Trends in Denials & Patient Responsibility

A XIFIN analysis of aggregated client data and denial trends reveals billing policy changes are impacting laboratory financials and patient out-of-pocket expenses. Without proper workflow automation, increased denials are also impacting back-office productivity.Over the last eight years, the diagnostics industry has realized a significant decrease in revenue due to numerous reimbursement cuts....

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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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Black Book Market Research Survey Shows Sharp Rise in Clinical Outsourcing Partnerships

Are you thinking of outsourcing your billing and revenue cycle? Well, you're not alone — A recent Black Book Market Research survey reveals a sharp increase in clinical outsourcing partnerships due to the pressures of value-based care reforms.The survey said the top two reasons for outsourcing services are cost savings/avoidance (selected by 85% of respondents) and the expertise of the...

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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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Suggestions for the Lab CIO

In the complex healthcare environment, there is always more to learn about any role within a lab. Recently, we had the opportunity to connect with thought leaders and technology experts at our CIO roundtable, and we came out with the following suggestions that we think can help the progress of the CIO role particularly:Use Technology That Supports the Use of DataIn XIFIN CEO and Executive...

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The Impact of Surprise Bills - What's Your Lab Going to Do About It?

In the time of information accessibility, patients are still left in the dark when it comes to their insurance coverage, which leads to surprise medical bills flooding one out of five American mailboxes. This distress creates a negative ripple effect that not only disrupts their financial situation but also affects labs. How did this happen?According to Kaiser Family Foundation, 72% of health...

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Integrating Laboratory and Clinical Data: A Framework for Improving Reimbursement of Genomic Testing

IntroductionIn 2017, there were roughly 75,000 genetic tests on the market with about ten new tests added daily.1 The rapid expansion of genomic testing, particularly next-generation sequencing (NGS) panels, has led to uncertainty about their appropriate use, interpretation, and clinical utility. Indefinite clinical utility leads to claims denials which are appealed through a lengthy...

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