Pre-authorization of molecular tests and the demand for clinical lab data and utilization reports
Managed-care companies are about to target expensive molecular and genetic tests by requiring pre-authorization and patient counseling. In addition, regional and national health insurers now require that all network laboratories provide them with clinical data and utilization reports on these tests. These requirements are the latest trends to hit managed-care contracting, and pose a direct threat to every clinical laboratory and pathology group-including yours. In 2010, payers will emphasize both requirements when renewing managed-care contracts with clinical laboratories and pathology group practices. How your lab addresses these issues during renewal negotiations could determine just how good your contract will be.
If you work for a regional lab, hospital laboratory outreach program, or pathology group practice, you won't want to miss the latest DARK REPORT and DARK DAILY audio conference, "Managed Care's Most Significant New Trends in 2010 and Their Impact on Your Lab's Contract Renewal Negotiations," on Wednesday, March 17, 2010. Get direct access to two of the nation's leading experts who will provide several proven strategies your lab can use during managed-care contract renewal talks to get a fair agreement.
First, Michael Snyder, President of Laboratory Management Services, will give you the most current information on the new pre-authorization requirements for molecular and genetic testing. Find out why payers are taking this step, and why some are even using third-party companies to handle it. You'll also learn what factors payers consider when deciding whether to include or exclude a laboratory as a provider of these tests. Snyder, along with our second expert, Sam Merkouriou, President of the Rhodes Group, will also help you better understand why payers want clinical laboratory test data and timely utilization reports from regional labs and hospital lab outreach programs. Because national and regional health insurers are competing for business from employers, payers are increasingly differentiating themselves by creating electronic health records (EHRs) for beneficiaries. But for EHRs to be useful, payers must first get all the laboratory test data because it makes up 80% of a typical patient's permanent health record.
Find out how your lab or outreach program can leverage your lab's data sets-which often include inpatient, outpatient, and outreach-testing data-to negotiate more favorable terms during managed-care contract negotiations.
Finally, Merkouriou will provide details on the latest software and data systems your lab can use to create complete, accurate, and timely utilization reports that meet payer requirements. Find out how some of the nation's most innovative laboratories are taking the payer demand for data and turning it into an opportunity to negotiate expanded network access and better managed-care contract terms. And how you can, too!
Register today and you and your managed-care contracting team will get up-to-the-minute information about what payers are asking for-and how your lab can satisfy those demands-during managed-care contract renewal negotiations. You'll come away with a complete list of action items for your lab. Remember, you'll get never-before-shared information and insights about the two most important trends in laboratory managed-care contracting in 2010. This audio conference is your best way to tap into the latest intelligence and use it to improve your lab's relationship with the national and regional health insurers in your community.
THE DARK REPORT AUDIO CONFERENCE AT A GLANCE
DATE: Wednesday, March 17, 2010 TIME: 1 p.m. EDT; 12 p.m. CDT; 11 a.m. MDT; 10 a.m. PDT PLACE: Your telephone or speakerphone COST: $195 per dial-in site (unlimited attendance per site) through 3/5/10; $245 thereafter TO REGISTER: Click here or call 1-800-560-6363 toll-free
For one low price—just $195 (through 3/5/10; $245 thereafter)—you and your entire team can take part in this fast-paced, insightful audio conference. Best of all, you’ll be able to listen to the key questions that were asked the panelists when we open up the phone lines for live Q&A.
Here's just some of what you’ll learn during this insightful 90-minute conference recording:
- Why payers want to put the brakes on expensive molecular/genetic tests by requiring pre-authorization.
- How to provide timely updates of clinical lab test data to managed-care plans.
- The utilization reports that payers find most valuable and how to deliver them.
- How payers' need for lab data and utilization reports create opportunities for regional labs.
- How payers are using electronic health records (EHRs) as a competitive benefit to win employer business.
- Preparing for managed-care contract renewal negotiations by offering value-added lab-test data and accurate utilization reports.
- The potential problems with your lab's LIS and how to resolve them to produce timely lab data and utilization reports.
- How to determine payers' objectives during contract-renewal negotiations.
- How to prepare your lab for the new "code stack" requirements for timely reimbursement… and much more!
HOW TO REGISTER NOW: 1. Online 2. Call toll free: 800-560-6363.
Your audio conference order includes:
- A site license to attend the conference (invite as many people as you can fit around your speakerphone at no extra charge)
- Downloadable PowerPoint presentations from our speakers#
- A full transcript emailed to you soon after the conference
- The opportunity to connect directly with our speaker during the audience Q&A session
Order Now! Or for more information, call us toll-free at 800-560-6363.
Michael Snyder is President and co-founder of Laboratory Management Services, a management services company that provides value to the health insurance and laboratory industries. He has more than 25 years of experience in the management of clinical laboratories. The work Mr. Snyder also did inside a national health plan has given him the tools to form Clinical Lab Business Solutions (CLBS), a consulting firm focusing on business development for independent and hospital laboratories. Prior to forming CLBS, he was Vice President of Laboratory Networks for UnitedHealthcare (UHC). In that capacity, he directed the national strategy for laboratory services and participated in the development of UHC’s national provider network. Additionally, Mr. Snyder served as Director of Business Development for Mount Sinai Hospital’s Center for Clinical Laboratories, where he saw outreach revenues triple in the implementation of a business plan that focused efforts on billing solutions and demonstrated the medical center’s laboratory to attending faculty. Sam Merkouriou is a Medical Technologist with 25 years experience in laboratory and IT related fields. His strong IT background is supplemented with many years of experience in billing and LIS-related management. In 1996 he started a consulting services business in the laboratory arena, offering services in IT, interface development, software implementation, project management, and financial/billing consulting. As President of Rhodes Group, Inc., Mr. Merkouriou assumes an active, hands-on role in all client projects. Rhodes’s customers include healthcare providers and vendors. He is an expert in laboratory operations, especially outreach and billing, compliance software design and development and large-scale, cross-discipline implementations.
ACCENT® Continuing Education Credit The American Association of Clinical Chemistry (AACC) designates this program for a maximum of 1.5 ACCENT® credit hours towards the AACC Clinical Chemist’s Recognition Award. AACC is an approved provider of continuing education for clinical laboratory scientists in the states of California, Florida, Louisiana, Montana, Nevada, North Dakota, Rhode Island, and West Virginia.
Category: Pathology News