September 2024 Edition

September 2024 Edition

Full Focus: Steps to Protect Lab Revenue Against Upcoming Reimbursement Cuts

For years, clinical laboratories have operated under the constant threat of annual reductions to reimbursements for the services they provide. However, with more Medicare rate reductions set to take effect at the start of 2025, the industry must band together to push back against PAMA and other legislative actions that threaten their ability to serve patients.

Please join us at noon EDT, Wednesday, Sept. 25, 2024, as we welcome Erin Will Morton and Meghan Riley , policy advocates for the National Independent Laboratory Association, to provide a detailed look at clinical lab cuts over time and how Congress can address this issue. Dyana Williams , Director of Lighthouse RCM Solutions, will also be joining the call to share their view of the current reimbursement landscape and offer actionable steps labs can take now to safeguard their revenue amidst these changes.

We'll cover:

  • An overview of clinical lab reimbursement cuts in recent years and how this issue can be addressed by Congress.
  • Other Medicare and private payer initiatives limiting lab payments.
  • Steps labs can take to protect their revenue now.
  • Action steps to bring attention to this issue and the importance of laboratory medicine.

REGISTER HERE>



LATEST NEWS

2024 Best of the Lab Awards

best of the lab awards image and survey link

In recent months, we have conducted polls on LinkedIn to determine the best service providers in the medical laboratory industry! We asked for the lab community's help in recognizing the best of the best, and they responded by voting or nominating their own organizations or industry leaders.

If you haven't had a chance to sound off yet, or would like to vote again, now is your chance to do so! This final round of voting will close Sept. 30, 2024, so please be sure to vote here or share this poll with your colleagues. Thanks again for participating and helping us to highlight the best of the best in the lab industry.

Start the SURVEY>


Biden Administration Approves Broader Access to Mental Health and Substance Abuse Services

Last week, The Biden administration approved a regulation aimed at providing greater access to mental health and substance use services for the 175 million Americans covered by private insurance.

The move reflects a substantial expansion of benefit parity standards for health plans. The rule mandates private health plans to assess their provider networks, out-of-network payment rates, and utilization management procedures to guarantee uniformity between mental and physical healthcare, as outlined in a fact sheet.

Read more about this promising news for toxicology labs catering to behavioral health and addiction centers HERE>


Short Video: Due Diligence Checklist When Buying or Selling a Laboratory

due diligence when buying or selling a lab link and image

Are you exploring a potential sale of your medical laboratory or practice? Or maybe you're looking to buy a lab but are not sure where to begin. Check out this short video for a quick legal overview from McDonald Hopkins of the necessary items you will want to ensure are covered as part of your due diligence process.

Watch NOW>


Modern Healthcare Ranks Lighthouse 19th Largest U.S. Healthcare Consulting Firm

Word may have already gotten out, but we still want to take a moment today to celebrate our clients and dedicated team members who helped us again rank as one of the largest healthcare management consulting firms in the U.S.!

This is the second consecutive year Lighthouse has made Modern Healthcare 's list — we can't wait to see where we'll climb to in the years to come!



CANDIDATE SPOTLIGHT

Lighthouse candidate spotlight image and link

The Lighthouse "Candidate Corner" is a recurring monthly spotlight featuring some of the great lab professionals our recruiters work with each day. Check out a quick preview of one individual below, then click over to our blog to see all five candidates for September.

If you'd like to learn more about anyone listed in this section, or inquire about their ability to relocate, email us directly?here!

Histotechnologist

  • Education:?Master's degree in Science, concentration: Histology
  • Certification: HT (ASCP)
  • Preferred Location: Maine, Mass, Connecticut, New Hampshire, Vermont

View all candidates HERE>



RCM NEWS AND TIPS

Pitfalls to Avoid When Using Diagnosis Z-Codes

z-code mistakes blog image and link

Lighthouse billing and coding specialists have recently observed a rising trend of claim denials for laboratory services involving the Z00.00 diagnosis code. This code, which is used for general adult medical examinations without abnormal findings, often needs to be accompanied by additional diagnosis codes to avoid denials.

Read more>



Deep Dive: Key Billing Guidelines to Reduce Toxicology Denials

key billing considerations for toxicology labs image and link

A recent publication from Palmetto GBA highlights the fact that laboratory services are among the top service types found to make the highest number of billing errors. They categorize those billing errors into five areas of concern, with over 80% of them directly related to the clinical decision-making documented in each patient’s medical record as opposed to improper coding.

When treating pain management and substance abuse populations, strong clinical documentation supporting medical necessity is a critical factor influencing a lab’s profitability and sustainability. In this new guide, our RCM experts review some of our most frequently encountered toxicology billing concerns and how to avoid these mistakes and ensure your billing is compliant.

Full guidelines HERE>

It’s also important to keep in mind that an ICD-10 code is also not sufficient evidence in and of itself of medical necessity. There must be evidence of a physician’s intent to order a specific test and/or test methodology and/or specific targets for each and every patient for which the lab bills services. -- Liset Sanchez, Client Manager, Lighthouse RCM Solutions



UPCOMING CONFERENCES AND TRADESHOWS

1. Tennessee Pain Society Annual Meeting


2. American Pathology Foundation National Meeting


3. Southern Pain Society Pain Management Meeting


Tami Shaw

Lab revenue cycle manager - Consultant - USMC Veteran - General Class HAM Operator

2 个月

Great info, as always!

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