Key Takeaways Congress blocked scheduled Clinical Laboratory Fee Schedule cuts for 2026 through the Consolidated Appropriations Act, 2026, signed February 3, 2026. The 2026 PAMA reporting window ran May 1 through July 31, 2026, and has already closed. Labs reported private payer data from January through June 2025, not the outdated 2019 data originally planned. […]
Roey Hine
Senior Vice President of Practice Management
Roey Hine is Senior Vice President of Practice Management at PGM Billing, bringing more than 25 years of experience in physician and laboratory billing. She specializes in developing and implementing the policies, procedures, and system frameworks that help practices maximize reimbursement while maintaining compliance with federal and payer regulations.
Roey’s expertise spans insurance claims management, provider credentialing, and fee schedule analysis. She is PGM’s lead authority on laboratory billing, with deep knowledge of the compliance and reimbursement challenges that distinguish lab from physician practice billing.
She holds a Bachelor of Science in Business Administration and is a member of the Practice Managers Section of the Medical Society of New Jersey.
Posts by Roey Hine
Laboratory Billing Errors: Panel Coding, Modifier 91, and Consolidated Billing Gaps
Key Takeaways Organ and disease panel codes carry NCCI edits that block separate billing of individual components once the panel’s components have all been performed. Modifier 91 applies only to medically necessary repeat testing performed to obtain multiple results on the same day, not to work-arounds for frequency edits. Laboratories testing specimens for patients in […]
Denial Management FAQ: Process Questions Billing Teams Ask Most
Key Takeaways A rejection stops a claim before payer review; a denial means the payer reviewed it and declined to pay. Hard denials are not recoverable; soft denials can be corrected, resubmitted, or appealed — and the distinction should drive triage decisions. Medicare Part A and B redeterminations must be filed within 120 days of […]