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CAP offers update on UHC DDP program

Although United Healthcare's Designated Diagnostic Provider Program (DDP) is set to launch July 1, many labs who will be affected by the move to restrict outpatient lab payments for diagnostic services to a select group of in-network providers are still seeking...

Covid vaccine billing FAQ

As the U.S. continues to ramp up its efforts to administer Covid-19 vaccines, many providers have been inquiring about the process for becoming eligible to compliantly bill for vaccines.

With that in mind, the Vachette team has put together a helpful FAQ that covers Medicare payments, how to become a Mass Immunizer, compliant roster billing and more. The full document (PDF) may be downloaded below.

UHC placing ‘pre-pay’ review on some Covid claims

Multiple labs Vachette works with have recently received records requests from UnitedHealthcare to support their Covid-19 testing. While UHC isn't denying these tests for improper coding, the payments they've put on hold amount to nearly $1 million in some instances.

CMS boosts Medicare payment for Covid-19 vaccine administration

CMS announced the Medicare payment for administering Covid-19 vaccines has been increased in an effort by the Biden Administration to expand capacity and vaccinate as many adults as quickly as possible, according to a press issued by CMS today.

Surgical pathologist sought by private practice group

Advanced Diagnostic Pathology Associates, a physician-owned private practice group of four pathologists, is seeking a Surgical Pathologist with strong general pathology skills, the ability to handle high case volumes and excellent communication skills to join their rapidly expanding practice.

CEO update: Examining UHC’s Designated Diagnostic Provider Program and more

In this week's update, Vachette and Stark Medical Auditing CEO Mick Raich reviews UHC’s new Designated Diagnostic Provider Program that will restrict outpatient lab payments for labs who don’t gain entry. He also examines a number of recent audit findings and provides an update of the latest Covid billing issues.

HHS extends Provider Relief Fund reporting deadline, now asking recipients to register

After initially asking providers who received a distribution from the Health and Human Services Provider Relief Fund (PRF) to report on the use of those funds by Feb. 15, HHS is now allowing recipients more time to report due to the ongoing Public Health Emergency (PHE) and changes brought about by the latest COVID relief package.

Image by Jan Vašek from Pixabay

Free Webinar: Strategies for maximizing Covid opportunities in 2021

With the Covid-19 Public Health Emergency now set to stretch into at least mid-April 2021, labs and pathologists working to meet the testing demand must continue to refine their strategies as it becomes increasingly clear this will be a significant line of business throughout 2021.

Covid Billing

2021 Medicare Fee Schedule boost: See impact to pathology services

As part of the COVID relief and and appropriations package signed into effect Dec. 27, Congress took steps to mitigate significant fee schedule reductions for several specialties that were designed to offset payment boosts for evaluation and management (E/M) services.

Career Opening: Medical Billing Auditor

Vachette is seeking a Medical Billing Auditor to join our team! This position will be responsible for reviewing specialty specific reporting to ensure proper coding and billing guidelines are met by clients and billing agencies.

Career Opening: Client Administrator

Vachette is seeking a Client Administrator to join our team! The Client Administrator is the main point of contact with the physician, group, hospital administration, or directors for any of our clients that are being managed.

Pathology sees 9% cut in 2021 MPFS Final Rule

After a lengthy delay, CMS released the 2021 Medicare Physician Fee Schedule Final Rule Tuesday. It finalizes several telehealth flexibilities introduced during the public health emergency while also significantly overhauling reimbursements for evaluation and management (E/M) services.

Covid Billing

More bad news for revenue cycle operations amid the COVID pandemic

The health system shut downs that took place in April and May (and in some instances stretched further) are still having downstream effects on revenue cycle operations for many of our clients. Unfortunately, we are seeing multiple issues because of this.

CMS establishes $28 Medicare rate for eventual COVID-19 vaccine

In an effort to be prepared to hit the ground running once a COVID-19 vaccine is made publicly available, CMS released an interim final rule with comment period late Thursday that sets the Medicare payment rate for administering a single dose at $28.39.

Michigan latest state to enact surprise billing law

Michigan has become the latest in a string of states that have elected to tackle the issue of surprise billing after a number of federal bills to address the issue have stalled out or lost traction in recent years.

MolDX removes coverage for BioFire, GenMark respiratory panels

As of Oct. 1, MOLDX has updated their LCDs/Billing and Coding Articles for the Multiplex Nucleic Amplified Tests for Respiratory Panels to no longer cover the PLA codes 0098-0099U, U100U, and 0115U. These PLA codes represent respiratory panels using BioFire® or GenMark® platforms.

Phase 3 of HHS Provider Relief Fund opens Oct. 5

Providers still reeling financially from the COVID-19 pandemic will have another opportunity to apply for financial assistance through the HHS Provider Relief Fund beginning Monday, Oct. 5 when the program launches its third phase.

Covid Billing

Watch for limits on genetic testing as CMS looks to rein in spending

A recent edition of Laboratory Economics (Volume 15, No. 9, September 2020) featured an article examining the Office of Inspector General's (OIG) recent report detailing how genetic testing is driving an increase in Medicare spending on the Clinical Laboratory Fee Schedule (CLFS).

Who's reviewing revenue strategy with you at this time?

Are you billing all the correct CPT codes? You’d be surprised at what you might be missing. We will review your Fee Schedule/Charge Master at no cost.

That’s right. For free.

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