Billing for molecular (PCR) testing has become a critical area of focus for clinical laboratories, especially as the Centers for Medicare & Medicaid Services (CMS), Medicare Administrative Contractors (MACs), and the American Medical Association (AMA) offer overlapping — but sometimes conflicting — rules. Understanding the nuances of multiplex PCR billing under CMS/NCCI and AMA guidance […]
How to Choose the Right Billing Software for Labs
If you run a lab, you already know billing isn’t the fun part. It’s complicated, time-consuming, and full of opportunities for things to go wrong. The right billing software for labs changes that story. It automates the tedious stuff, catches errors before claims go out, and helps you get paid faster. But here’s the tricky […]
Top Laboratory Billing Companies: What to Look For
If you’re running a lab, you already know how complex and ever-changing the billing landscape can be. Reimbursement rules shift constantly. Coding gets updated. Payers deny claims for reasons that don’t always make sense. And the financial health of your lab can hinge on how well those claims are handled. That’s exactly why more laboratories […]
Top Challenges Facing Labs Today: 4 Key Takeaways From Lab Institute 2017
Representatives of Physicians Group Management (PGM Billing) recently returned from attending and exhibiting at Lab Institute 2017. This meeting, hosted by G2 Intelligence, brings together professionals from throughout the lab industry for three days of education and networking. In this ever-changing, ever-evolving healthcare environment, many sessions focused on the top challenges facing laboratories. Here are […]
Clinical Diagnostic Lab Tests Payment System Final Rule: FAQs from CMS
The Centers for Medicare & Medicaid Services (CMS) has published 45 frequently asked questions (FAQs) and CMS responses about the Medicare Clinical Diagnostic Laboratory Tests (CDLTs) payment system final rule. CMS announced on June 17 the release of the final rule, which implemented section 216(a) of the Protecting Access to Medicare Act of 2014 (PAMA). […]
4 Top Trends in Pathology Billing and Coding
Labs nationwide have faced significant billing and coding challenges over the past few years. These challenges are likely indicative of trends labs can expect to face in the coming years. Here is a quick snapshot of four of the top lab billing and coding trends. 1. Reduced reimbursement. Reimbursement cuts have hit providers of most […]