White Papers
Cigna to Cap PC Clinical Pathology Reimbursement at $5 Beginning July 1
Letters from Cigna dated April 1st, 2022, are not an April Fools’ Prank. It appears that Cigna is attempting a new additional tactic to manage their payment of the Professional Component of Clinical Pathology (PCCP).
Pathology Job Market Struggling to Meet Increasing Demand
"Gone may be the days where one person who was more broadly trained could effectively advise whole laboratories comprehensively on what patients need and how to go about arranging that as an in-house offering," says Tara Luellen, Vice President of Lab Director Services.
Case Study: Biller’s Contract Breach Results in Client Settlement
When a client went uncompensated for months of work due to a biller’s breach of contract, we were able to fight on their behalf to recover a $25,000 settlement.
Artificial Intelligence: Payers vs Medical Billers Round One
There are some interesting changes in the medical billing world surrounding artificial intelligence (AI). There is an AI war going on with payers and billers in the revenue cycle management (RCM) arena and the winner will be the one who invests in AI quickest and maintains their edge in technology. We are just beginning to see this technology utilized, but several firms are already in the game.
Cigna again moves to end PC clinical pathology payments
After holding off on the move during the summer amid significant pushback from pathology and lab advocates, Cigna appears to again be moving forward with its plan to end reimbursement for the professional component of clinical pathology (PC/CP) beginning Nov. 1, 2021.
A new managed care strategy for pathologists
The time has come for a new mindset. No longer should pathology contracts be tied to a draconian Medicare fee schedule hurtling towards the lowest payment possible.
2022 Proposed MPFS: See impact to pathology, labs
Pathologists and independent laboratories will experience a handful of significant payment reductions for key services if CMS adopts changes released Tuesday in the 2022 Medicare Physician Fee Schedule (MPFS) Proposed Rule.
Cigna to continue paying professional component of clinical pathology
After previously stating its intent to stop paying the professional component of clinical pathology, Cigna has reversed course and will continue paying for these services, according to CAP.
Case study: A/R collection strategy leads to $120k in recovered payments
Recently, Vachette was hired by a laboratory client under new management to review their outstanding accounts receivable (A/R). The goal was to assess the full scope and realistic collectability of their outstanding payments, while at the same time analyzing the...
A path forward as Cigna ends PC clinical pathology payments
Recently, Cigna announced it will longer going to pay for the professional component of clinical pathology (PCCP) beginning July 11. This comes as no surprise; we have seen this coming for the past few years as UnitedHealthcare, Humana and Aetna have made similar moves.
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.