Category: For Laboratories

Keeping you in the know on the constantly changing world of medical billing and reimbursement, Quadax compiles industry news and articles covering important revenue cycle topics impacting the lab industry. 

	Coronavirus (COVID-19)
	COVID-19 Testing, Treatment and Future Outlook (WEBINAR) 360DX This 6/4 webinar will discuss the current status of COVID-19 testing, treatment and other aspects of the current pandemic as they relate to getting this outbreak under control.  [Read more] CDC streamlines lab test result reporting by sharing COVID-19 results reported to public health agencies with HHS system AHA To streamline the reporting of COVID-19 lab test results, the Centers for Disease Control and Prevention yesterday encouraged all U.S. hospital laboratories to submit their COVID-19 testing information to their state or local public health department following their normal protocol for reportable conditions. [Read more]
	Lack of routine testing puts labs in financial pinch Becker’s Hospital Review Two of the largest diagnostics companies, Quest Diagnostics and LabCorp, have both taken a hard hit to their finances due to a lack of routine testing.  [Read more]
	COVID-19 Information CAP COVID-19 Resource Center for labs including recent updates and responses to COVID-19 questions. [Read more]
	COVID-19 Precipitates Sharp Decline in Cancer Testing, Diagnoses Clinical OMICs  Regular screening is down due to reduction in the number of people having medical appointments, and repurposing of lab resources toward providing COVID-19 testing has impacted these labs’ ability to providing oncology testing. [Read more] NIH Launches $1.5B Rapid COVID-19 Testing Technology Challenge Clinical OMICs A new initiative announced by the National Institutes of Health, backed by a $1.5 billion investment from federal stimulus funding, aims to speed innovation, development, and commercialization of COVID-19 testing technologies.  [Read more]
	Quality Issues Your Clinical Laboratory Should Know Before You Buy or Select COVID-19 Serology Tests (WEBINAR) Dark Daily Dark Daily is offering this FREE webinar on 5/21 in support of clinical laboratory professionals and pathologists. [Read more]
	With So Many New COVID-19 Serology Tests Obtaining EUAs from the FDA, How Can Clinical Laboratories Identify Tests That Should Perform Reliably? (ADDED 5/20) Dark Daily As federal and state officials ease many regulatory requirements to speed new COVID-19 serology tests to market with minimum data about performance, labs are left with important questions to answer on their own. [Read more]
	Policy for Coronavirus Disease – 2019 Tests During the Public Health Emergency (Revised) FDAImmediately in Effect Guidance for Clinical Laboratories: FDA is issuing this guidance to provide a policy to help accelerate the availability of novel coronavirus (COVID-19) tests developed by laboratories and commercial manufacturers for the duration of the public health emergency. [Read more] Labs push back on WH testing claims citing lack of critical supplies The HillAcademic medical labs pushed back Tuesday on the Trump administration’s assertion that they are underutilizing COVID-19 testing equipment that could help increase the country’s diagnostic testing capacity. [Read more]
	Molecular DiagnosticsNew Method for RNA-Seq Helps Unravel Data from a Mixture of People Clinical OMICs The Souporcell technique could help study how genetic variants in different people affect which genes are expressed during infection or response to drugs. [Read more]
	Payer News
	Health Insurance Providers Respond to Coronavirus (COVID-19) AHIP List of health insurance providers activating emergency plans to ensure that Americans have access to the prevention, testing, and treatment needed. [Read more] COVID-19: Modified Ordering Requirements for Laboratory Billing CMS MLN Connects (5/7/2020 Issue) During the COVID-19 Public Health Emergency, CMS is relaxing billing requirements for laboratory tests required for a COVID-19 diagnosis. [Read more] Cost Share Covered for COVID-19 Antibody Testing UnitedHealthcare  UnitedHealthcare will cover FDA-authorized COVID-19 antibody tests ordered by a physician or appropriately licensed health care professional without cost sharing (copayment, co-insurance or deductible). [Read more]

Keeping you in the know on the constantly changing world of medical billing and reimbursement, Quadax compiles industry news and articles covering important revenue cycle topics impacting the lab industry. 

	Coronavirus (COVID-19)
	Breaking News on Novel Coronavirus Testing 360DX Breaking news on coronavirus testing, with real-time reporting on assays to detect the SARS-CoV2 coronavirus, which causes COVID-19. [Read more] AACC Asks Congress to Wait on LDT Regulation During Coronavirus Outbreak AACC AACC called on lawmakers to pause consideration of a bill that would expand FDA regulation of laboratory-developed tests until the full effects of the virus on the healthcare system can be evaluated. [Read more]
	Biodesix Begins Coronavirus COVID-19 Testing Biodesix Biodesix, Inc., a leading diagnostic company in lung disease, announced that it began SARS-CoV-2 Droplet Digital PCR (ddPCR) testing for the virus that causes COVID-19 and will immediately submit for Emergency Use Authorization from the Food and Drug Administration.  [Read more]
	COVID-19 Information CAP COVID-19 Resource Center for labs including recent updates and responses to COVID-19 questions. [Read more]
	COVID-19: A Catalyst For Innovation In Clinical Research? Clinical Research News The novel coronavirus (COVID-19) has presented numerous challenges for clinical research. While some trials for a COVID-19 vaccine have already begun, it will take time before any progress is made for a publicly available drug. And in the meantime, clinical trials not dedicated to the pandemic are struggling to remain operational. [Read more]
	What Hospital and Health System Labs Need to Know About Operational Support and Logistics During the COVID-19 Outbreak Dark Daily Dark Daily is offering this FREE 60-minute webinar in support of clinical laboratory professionals and pathologists. [Read more]
	Diagnostic Test Kits, Commercial Labs Granted Emergency Use Authorization In Wake Of COVID-19 Diagnostics World The diagnostics community has come out in force to address testing issues for the novel coronavirus. As of April 3, 25 test kit manufacturers and commercial laboratories have been issued Emergency Use Authorization from FDA, and many commercial and healthcare system/academic laboratories have notified the FDA that they have validated their own COVID-19 test and have started patient testing. [Read more] Virtual Town Hall Series – Immediately in Effect Guidance on Coronavirus (COVID-19) Diagnostic Tests FDAOn April 15, 2020, from 12:15 pm – 1:15 pm Eastern Time, the U.S. Food and Drug Administration (FDA) will host a virtual Town Hall for clinical laboratories and commercial manufacturers that are developing or have developed diagnostic tests for SARS-CoV-2. [Read more] FAQs On FDA Guidance For Clinical Trials During The COVID-19 Pandemic IMARC ResearchThe FDA added an appendix with frequently asked questions and answers on its previously released guidance document on Conduct of Clinical Trials of Medical Products during COVID-19 Pandemic. Here are some key takeaways from the most common questions. [Read more]
	JAMA Coronavirus Disease 2019 (COVID-19) JAMA Network Browse the JAMA Network COVID-19 collection, including Q&A’s with NIAID’s Anthony Fauci, an interactive map of the outbreak courtesy of The Johns Hopkins Center for Systems Science and Engineering, and past publications on vaccine development, infection control, and public health preparedness. [Read more]
	FDA announces availability of reference sequence data for SARS-CoV-2 Medical Laboratory Observer The Food and Drug Administration—in collaboration with the CDC, BEI Resources, NCBI and NIH— have developed quality-controlled reference sequence data for the SARS-CoV-2 reference strain for the United States. [Read more]
	GenomicsCancers’ Complexities, Commonalities Detailed in Extensive Genomic Analysis AACC A massive undertaking involving more than 1,300 scientists from 37 countries reported in 23 papers shows the results of analyzing 47 million genetic changes in 2,600 genomes of 38 different tumor types. The Pan-Cancer Analysis of Whole Genomes presented what the researchers called “the most comprehensive study of whole cancer genomes to date.” [Read more]
	Payer
	Blue Shield of California is offering providers up to $200 million during COVID-19 crisis Healthcare Fiance The nonprofit insurer is working with two financial-services partners to provide financing guarantees, advance payments and restructuring of contracts. [Read more] UnitedHealth Group Accelerates Nearly $2 Billion in Payments and Support to Health Care Providers to Help with COVID-19 Financial Challenges United HealthcareUnitedHealth Group will accelerate nearly $2 billion in payments and financial support to U.S. hospitals and healthcare providers to help address the significant financial pressure many are facing due to COVID-19. [Read more]
	Industry News
	Because of the COVID-19 Outbreak, AACC Reschedules Its Annual Conference to December in Chicago and Executive War College Reschedules Its Conference in New Orleans to July Dark DailyTwo major clinical laboratory conferences reschedule: American Association of Clinical Chemistry moves from July to December 13-17 in Chicago and Executive War College moves from April to July 14-15 in New Orleans. [Read more]

Keeping you in the know on the constantly changing world of medical billing and reimbursement, Quadax compiles industry news and articles covering important revenue cycle topics impacting the lab industry.

STAT

The push to increase testing in the U.S. for the novel coronavirus that causes Covid-19 has hit a new stumbling block: shortages of key chemicals needed to start up and run the tests. [Read more]

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By definition, consumerism is a social and economic order that encourages the acquisition of goods and services in ever-increasing amounts. Continue reading “A New Era of Consumerism Facing Labs Today – How Do You Stay Competitive?”

Nearly 60% of insured adults have received a surprise bill on a healthcare service they thought was covered by insurance. And whether care or the provider is in-network, out-of-network or a mix of the two, 1 in 5 of these insured adults find it difficult to pay their deductibles.² Why is this happening and what is being done about it?

Due in part to narrow provider networks, surprise bills can be the financial result of a patient receiving in-network care by an out-of-network provider, often the bill being the difference between the charged and the allowed amount of a service. These surprise bills can cause undue stress and have detrimental financial effects on the entire household, such as delayed payment on other household expenses, mounting credit card debt, and more. As such, state and federal legislations are responding in kind with laws around surprise bills.

STATE LEGISLATION

A number of states have enacted comprehensive laws to protect some patients from surprise medical bills, including California, Oregon, Illinois, Florida, New York, New Hampshire, New Jersey, Connecticut and Maryland. Additional states, including Texas, Colorado, New Mexico, and Washington, have passed laws expected to take effect this year. In essence, these laws are meant to protect consumers from surprise bills by limiting providers to the applicable in-network cost, setting a state payment standard, and/or establishing a dispute resolution process.³ Meanwhile, more than a dozen more states have enacted a limited approach to mitigate surprise bills.

FEDERAL LEGISLATION

Federal action is necessary to address certain aspects of surprise bills for people enrolled in self-funded plans due to the Employee Retirement Income Security Act of 1974, or ERISA.  Legislation is expected to be passed in fall of 2019.

Both state and federal initiatives can be summed up as:

• All proposed legislation includes a ban on balance billing patients
• Most legislation is specific to emergency and ancillary providers at this time
• Many of the proposed state and federal bills include stipulations for using usual and customary rates as a basis for negotiation
• Arbitration clauses included in many of the proposed bills is considered favorable to providers
• Indexing against usual and customary rates seems to be included in more of the state initiatives

What can you do?

To help avoid and mitigate the risk of surprise bills, more and more hospitals and clinical laboratories are rethinking the patient experience and investing in tools to help provide pricing transparency on procedures and services, like testing. These tools utilize basic patient demographics (name, birthdate, address, insurance provider, etc.) to validate insurance coverage and eligibility, perform advanced benefit investigation to uncover plan-specific coverage details, assess prior authorization rules, and most importantly provide a patient’s expected out-of-pocket cost. Taking it even further, labs can identify a patient’s propensity and willingness to pay to help assess the need to offer financial assistance. This entire approach, called Patient Access Management, can help clinical labs and providers alike offer the transparency needed to empower a patient to make financial decisions regarding their care – perhaps the patient cannot afford the test so an alternative treatment plan has to be put into place. Patient Access helps to improve the patient experience in that the patient understands exactly what they will owe for the test – and no surprise bills. For a growing molecular lab, this can mean the difference between writing off bad debt and securing expected revenue.

To learn more about Patient Access Management solutions offered by Quadax and how they can help mitigate the risks of surprise bills and more, contact us today!

1. http://www.norc.org/NewsEventsPublications/PressReleases/Pages/new-survey-reveals-57-percent-of-americans-have-been-surprised-by-a-medical-bill.aspx
2. https://www.consolidatedcredit.org/infographics/medical-debt/#gref
3. https://www.healthsystemtracker.org/brief/an-examination-of-surprise-medical-bills-and-proposals-to-protect-consumers-from-them/#