Industry Insights
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HHS & CMS Secure Major Reforms to Prior Authorization
ON THIS PAGE What HHS and CMS Are Doing Context: Building on Earlier Reforms Implications for Laboratory Professionals Implications for OB/GYN Physicians Bottom LineDate: June 23, 2025 (U.S. Department of Health & Human Services press release) Published: July 7,...
UnitedHealthcare’s Z-Code Requirement for Genetic Testing Claims Impacts Laboratories and Payers
UPDATE: 10/1/2024 UHC began phase 3 of the DEX Z-codes registration. "Claims eligable for phase 3 tests with dates of service on or after Jan. 1, 2025, need to include the appropriate Z-Codes to be considered for reimbursement." Genetic and pathology laboratories are...
CMS Makes Improvements to Prior Authorization Process
The Centers for Medicare & Medicaid Services (CMS) has released the CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F) on January 17, 2024. The rule aims to advance interoperability and enhance prior authorization processes in healthcare. It...
Cigna Announces Rollback of Prior Authorization Requirements
Cigna has taken a significant step towards simplifying the healthcare process by eliminating prior authorization requirements for 25 medical procedure codes. This decision is in line with Cigna's ongoing efforts to enhance patient care and reduce administrative...
Why and How Your Lab Can Support SALSA
"With strong bipartisan and bicameral support of SALSA, Congress has the opportunity to fix the flawed PAMA framework and prevent reduced access to essential testing, stifled innovation, and weakened laboratory infrastructure essential to public health preparedness....
Blogs
HHS & CMS Secure Major Reforms to Prior Authorization
ON THIS PAGE What HHS and CMS Are Doing Context: Building on Earlier Reforms Implications for Laboratory Professionals Implications for OB/GYN Physicians Bottom LineDate: June 23, 2025 (U.S....
Genomic Lab Billing 101
ON THIS PAGE Why Genomic Lab Billing Matters What Is Genomic Lab Testing? Key Differences from Molecular Lab Testing Challenges in Genomic Lab Billing and Reimbursement Understanding Genomic Lab...
How to Choose A True Pathology Billing Company
ON THIS PAGE The Challenges Facing Independent Pathology Labs The Costly Consequences of Choosing the Wrong Pathology Billing Company How to Choose the Right Pathology Billing Company Know What...
Genetic Lab Billing Services for OB/GYN Revenue
ON THIS PAGE The Growth of Genetic and Molecular Testing in OB/GYN PracticesThe Complex Nature of Genetic Lab Billing and Why It Requires ExpertsThe Impact of Molecular Laboratory Billing Services...
Fertility Billing Services for Ancillary Lab Revenue
ON THIS PAGE Why Lab Revenue Is Often Overlooked in Fertility ClinicsObtaining New Revenue From Fertility Laboratory TestingThe Unique Challenges of Fertility Laboratory BillingReducing Cost of...
Revenue Opportunities for OBGYN Profitability
ON THIS PAGE Unlocking the Full Potential of OB/GYN RevenueHow Ancillary Laboratory Services Costs Impact OB/GYN RevenueHow the Right Laboratory Reimbursement Strategy Can Boost OB/GYN...
How Physicians Can Reach the Full Potential of Ancillary Laboratory Services
Ancillary services play a crucial role in enhancing patient care while supporting the operational and financial health of physician practices. Among these services, ancillary diagnostic services,...
Laboratory Medical Billing – Decisions of Profitability
The Complex Landscape of Laboratory Medical Billing The success of a lab truly lies in the foundation of the success of it's laboratory medical billing process. Without proper reimbursement, labs...
Optimizing Revenue with Specialized Pathology Billing Practices
In the ever-evolving landscape of healthcare, pathology practices are faced with the constant challenge of maximizing revenue while providing accurate and efficient diagnostic services. Pathology...
