Quadax Blog

Prior Authorization – The Lab’s Dilemma

How are some of the payers’ Prior Authorization (PA) programs impacting your laboratory’s bottom line and what can you do about it? Increasingly, retroactive authorization after performing lab tests is becoming a less viable option; as is fighting denials for lack of Prior Authorization during the appeal process. While some payers still allow retroactive authorization, in general, laboratories [...]

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Three Ways Providers Can Prepare for MBI Impact

***UPDATE: MBI Lookup Tool Now Available through Your MAC***

All Medicare Beneficiary Identifier (MBI) lookup tools are ready for use on Medicare Administrative Contractor (MAC) secure portals. If you don’t already have access, sign up for your MAC’s portal to use the tool.

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OPPS 2018 Revisions:  Outpatient 14-Day Rule Changes to Laboratory DOS Policy

Centers for Medicare and Medicaid Services (CMS) published its final rule with comment period revising the Medicare Hospital Outpatient Prospective Payment System (OPPS) for 2018. Labs that provide services to hospital outpatients may want to review the new OPPS rule changes, particularly the revisions to the laboratory date of service (DOS) policy (see CMS excerpt highlighted below).  

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Is Your Lab Aware of CMS Claim Requirements for “Unlisted” Test Codes?

Centers for Medicare & Medicaid Services (CMS) released Transmittal 3881 on Friday, Oct. 13, 2017 requiring the submission of data for lab tests processed with “unlisted” codes effective beginning January 16, 2018. Medicare Contractors (MACs) will report to CMS specific laboratory tests and associated claims data for any test paid under the Clinical Laboratory Fee Schedule (CLFS) as a Not [...]

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FASB New Standard on Revenue Recognition – Are You Ready for ASC 606?

With effective dates looming, ASC 606 implementation readiness is top of list for many executives. All entities that enter into contracts with customers will need to be prepared. Effective dates are set to begin after December 15, 2017 for public entities and after December 15, 2018 for nonpublic entities. The intent of the new Accounting Standards Update (ASU) No. 2014-09 is to establish a [...]

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About This Blog

We write about topics relevant to the complex world of revenue cycle management. Our posts feature best practices, helpful ideas, and industry trends in areas such as patient access, claims management, reimbursement, regulatory compliance, and much more! 

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