Full Focus: How to Improve Contract Negotiations and Get In-Network
Has your lab or practice encountered obstacles when trying to determine how to get in-network with new payers to expand your footprint? And if you become a participating provider, how do you approach improving your contract when the time comes to renegotiate?
Join us for our next webinar at noon EST, Wednesday, Feb. 28, as we welcome experts from our Revenue Cycle Management and Payer Strategy divisions to offer insight on how labs, pathologists, and other specialists should approach their contracting strategy to make their group appealing to new payers and negotiate a favorable contract. If you have limited experience with third-party reimbursements or the overall payer landscape, this event will equip you with the tools you need to enter your next negotiation with confidence.
During this webinar, we’ll discuss:
- Strategies for joining new payer networks.
- How to appeal to closed or narrow networks.
- Tips for negotiating contracts.
- How the landscape differs for labs vs pathologists.
- Ancillary items that can appeal to payers.
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1. The FDA Can't Reclassify Its Way Out of Reviewing 10,000 LDT Submissions
The FDA recently announced it would initiate the reclassification process for most IVD products that are currently class III (high risk) into class II (moderate risk). Reclassification would allow developers to seek clearance for substantially equivalent tests through the 510(k) pathway rather than the more costly and time-consuming premarket approval pathway.
What does this move mean in the ongoing debate concerning oversight for laboratory developed tests? According to the latest analysis via Hyman, Phelps & McNamara, P.C.'s FDA Law Blog, this is likely a preemptive attempt to lower the agency's premarket IVD review load.
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2. Lighthouse Now Offers Instrument Service
Is your instrument service contract up for renewal, or has your warranty recently expired? Lighthouse Lab Services offers instrument maintenance and procurement services and is ready to show you why our engineers are best-in-class for both knowledge and response time. Specializing in preventative maintenance for LCMS Instruments and Chemistry Analyzers, our certified engineers use parts from original manufacturers, adhere to the highest industry standards, and can be relied on to keep your instruments operating at peak performance.
Check out our website for more on our service options or reply to this email for a free consultation to learn more.
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3. Tips for Creating a Positive Work Culture in Your Lab
In a laboratory setting, a positive work culture isn’t just a boon for morale—it’s a catalyst for innovative thought, quality research, and enhanced productivity. Creating and maintaining this encouraging environment is crucial for the success of your researchers and the scientific community. Here are some tips for creating a positive work culture in your lab to propel your team toward increased collaboration, job satisfaction, and overall output.
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The Lighthouse "Candidate Corner" is a recurring monthly spotlight featuring some of the great lab professionals our recruiters work with each day. Check out a quick preview of one individual below, then click over to our blog to see all five candidates for February.
If you'd like to learn more about anyone listed in this section, or inquire about their ability to relocate, email us directly here!
Candidate - Director of Laboratory Services
- Education:
- B.S. in Core Lab Science, M.S. in Organizational Leadership
- Experience/Expertise/Specialty:
- MLS(ASCP) certified Generalist
- 18 years of lab experience
- 8 years in director-level positions
- Preferred Location:
- Chicago, IL, area
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1. 2024 Trends and Challenges in Lab Billing and Coding
What are the top billing and reimbursement challenges facing labs in the coming year? Ann Lambrix, VP of RCM Consulting for Lighthouse, recently sat down with G2 Intelligence for a wide-ranging conversation on the RCM challenges currently facing labs, placing particular emphasis on analyzing your payer mix when considering whether to expand your test menu.
The conversation also touches on best practices for obtaining documentation, the benefits of routine auditing, managing back-end denials, and more. Check out the full piece below.
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2. New Medicare Specimen Collection Fees for 2024
If you previously missed the announcement, don't forget that Medicare has updated phlebotomy specimen collection and travel allowance fees for 2024:
- Specimen collection fees are now set at $8.83, a 3% increase over the previous rate of $8.57.
- Collection fees for skilled nursing centers also received a 2.5% increase to $10.83.
- Additionally, the flat-rate base trip allowance was boosted by 20 cents to $11.30, while the per rate mile received a two-cent increase to $1.13.
As noted by our RCM Solutions Team, labs should be sure to raise their rates on their charge master/fee schedule to reflect these increases. Medicare won't reimburse $8.83 for each specimen collected if you're charging outdated rates!
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Deep Dive: Transforming Hospital Labs from Cost Centers to Profit Generators |
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While some hospital administrators may view their labs as cost-centers, this stance can lead to profitable testing being outsourced instead of performing the service in-house. Most hospital Lab Directors understand this dynamic but are unable to successfully lobby administrators to expand their testing capabilities beyond core services due to a lack of time and resources to present the business case.
In this recent article for Medical Laboratory Observer, Lighthouse President Jon Harol outlines why hospital labs would benefit both themselves and their patients by adding high-margin services such as toxicology confirmation testing utilizing liquid chromatography-mass spectrometry (LCMS) and next-generation sequencing for cancer.
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“If you require a lab to be able to service patients 24/7 with a broad test menu, it’s very hard to operate that on a profitable model given reimbursement assigned for many of those tests by federal and commercial payers. If you get so in the weeds that you only perform the low-margin testing and completely pass over higher-margin testing, that’s the worst-case scenario.”
-Jon Harol, President, LLS
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UPCOMING CONFERENCES & TRADESHOWS |
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1. Clinical Lab 2.0
2. Pennsylvania Pain Society
3. 2024 Tox Expo
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This email is brought to you as a service from Lighthouse Lab Services to provide quality and timely information that can improve your laboratory operations. We strive to maintain our position as the country’s premiere lab consulting firm and support your success. |
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The Lab Insighter is a monthly publication for Lab Owners and Decision Makers.
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Contact us at:
(919) 443-6553
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