Category: For Laboratories

From Appeals to Adoption: Accelerating Change in Personalized Medicine Reimbursement
Interview with Tom Cronin, Senior Vice President, Revenue Cycle Strategy & Analytics at Quadax and Perry Dimas, The Promise of Personalized Medicine

The fight for reimbursement often feels like navigating a maze. From lengthy appeals to prior authorizations, labs and healthcare providers must balance innovation with complex payer policies. But what if this process could be less adversarial, more collaborative, and streamlined with the help of cutting-edge technology?

In this interview, Tom Cronin acknowledges that while appeals can be a necessary tactic to challenge denied coverage, they are costly and time-consuming. He contrasts older adversarial approaches with today’s more collaborative methods, where payers increasingly appreciate the economic value of tests in the long-term healthcare of patients. He explains how medical policies and prior authorizations play a critical role in determining coverage, while also discussing the evolving trend of health plans requesting medical records electronically to streamline the process.

Listen here