Latest News

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).

As UHC limits OON lab services, questions arise surrounding timing

At a time when patients and providers alike are being severely impacted by the COVID-19 Public Health Emergency, UnitedHealthcare (UHC) has taken the opportunity to push some aggressive policy changes to limit care -- all while reaping record profits.

Are pathology cuts justifiable as we expand telehealth?

Can it be argued that these cuts may be premature? Could it be by 2021 that seeing your family doctor virtually will be the norm? Consider that the overhead costs for virtual medicine are considerably less than for actual face-to-face encounters.

Vachette weekly update — 8/17/2020

In his latest update, Vachette and Stark CEO Mick Raich explores a number of new policy changes from UHC that are continuing to hurt labs during a vulnerable time.

Is pooled testing the solution for your lab?

At a time where the nations laboratories are continuing to struggle with meeting the COVID-19 testing demand, some officials have recommended the strategy of pooled testing as a means to cut down on the overall testing cost and workload.

Vachette weekly update — 8/3/20

This week, Vachette and Stark Medical Auditing CEO Mick Raich discusses a number of COVID-19 related issues, including what the extension of the Public Health Emergency means for ordering tests.

Vachette news and COVID roundup — 7/27/20

This week, Vachette CEO Mick Raich discusses the continued push for hospital price transparency, outlines the penalties you could face if your COVID-19 testing cash price isn’t listed publicly on your website and examines a few other COVID-related reimbursement issues.

Clinical Pathology service as backbone of an Anatomic Pathology group

Strong clinical pathology service is the foundation of a good health system relationship. This is the premise on which Tony Kubat, M.D., the President of Michigan Pathology Specialists, leads his 26-person pathology group in working with Spectrum Health System in Western Michigan.

Vachette news and COVID-19 roundup — 7/20/20

With Covid-19 showing no sign of slowing down in the near future, many health care providers need to prepare for a potential resurgence this fall that could lead to another pause on elective surgeries or a more comprehensive nationwide shutdown.

COVID-19 is not done impacting your revenue

With the next round of COVID-19 infections making the news, we are seeing some states and health systems closing down elective surgeries again. This will drastically affect health care providers as many are only now seeing cash return to pre-COVID levels, while others are still struggling to get their cash flow back in line.

Job Opening: Client Administrator

Vachette is seeking a talented, highly motivated individual with an in-depth knowledge of practice management to join our team.

Paying for referrals equals federal investigation

As it is alleged, this lab paid people to send their COVID tests to their lab. Needless to say, this is an obvious violation of anti-kickback laws and you can expect the DOJ will throw the book at those involved in the scheme when their investigation concludes.

Even the government knows providers can’t audit themselves

Ultimately, when we do review these self-audit sites, we find their error rates to be higher than the standard industry rate of 5 percent, sometimes as high as 20 percent. So why are some groups happy to continue down this route?

HHS clarifies data labs must submit for COVID-19 testing

Last week, the Department of Health and Human Services (HHS) issued additional guidance for labs and other entities performing COVID-19 testing regarding exactly what demographic data is required to be submitted to local health authorities. While these requirements...

Watch for bad billing practices due to COVID fallout

Lately, we have found several clients with issues surrounding claims submission. These issues include duplicate billing, failed submissions to clearinghouses and unworked front-end edit reports.

How COVID-19 could drive surprise billing changes

While the discussion surrounding a nationwide solution for surprise billing was a hot topic until earlier this year, there are now many legitimate questions to be asking about how COVID-19 may drive the push for new legislation.

The pitfalls of the instant billing world

We often get these calls from groups or firms with a large amount of capital and very little knowledge of what it takes to get through the correct processes to get paid. Instead, they call us requesting magic.

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.

Share This