Management of Pathology Practices

Revised: 9 August 2017, (c) 2004-2017, PathologyOutlines.com, Inc.
Management related: Jobs, Fellowships, Conferences, CME
Related chapters: Computer Systems, Laboratory Administration
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The articles below have been written or adapted exclusively for PathologyOutlines.com. They reflect the views of the authors, and not necessarily those of PathologyOutlines.com. Contributors have paid a fee to appear on this page. The Management chapter below is a compilation of information from various sources, including those listed under Primary References.


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Recently Posted Articles
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Lab Prior-Authorization Programs Continuing to Evolve by Mick Raich, Vachette Pathology, posted 9 August 2017
With United Healthcare set to unveil a national prior-authorization process for genetic and molecular testing for fully insured members on Oct. 1, most major health plans are now utilizing some form of a laboratory benefits management (LBM) program in various parts of the country. But what's driving this trend? For starters, many of these insurers are finally admitting they lack the necessary expertise in the laboratory field to determine medical necessity and properly rein in potential fraud and abuse within the industry. Rest of article

What Pathologists Can Expect from the 2018 Medicare Physician Fee Schedule by Mick Raich, Vachette Pathology, posted 26 July 2017
After significantly cutting the technical component for a number a key of pathology CPT codes last year, pathologists should be relieved to hear the vast majority of reimbursements levels are expected remain relatively unchanged next year, according to the proposed 2018 Medicare Physician Fee Schedule. The biggest hit will again impact the Global and Technical reimbursements for prostate biopsies (G0416). Rest of article

6 Highlights of the 2018 MIPS Proposed Rule by Mick Raich, Vachette Pathology, posted 17 July 2017
While many clinicians are still working to get a handle on the requirements for the Merit-based Incentive Payment System, they also need to keep an eye on how the program is expected to evolve next year now that CMS has released its 2018 Quality Payment Program Proposed Rule. However, those fearing the bar for penalty avoidance would be raised to unreasonable heights should breathe easy knowing CMS won't require much more from you than what they asked for in 2017. Rest of article

How Do You View The Pathology Recruitment Market? (Survey) by Mick Raich, Vachette Pathology, posted 28 June 2017
How do you view the current state of the pathology recruitment market? What kind of future do you see for the practice of pathology in the Unites States moving forward? We're seeking pathologists to help answer these questions and more as part of a survey that will be discussed during a group panel at the upcoming Association of Pathology Chairs Annual Meeting, July 25-28 at in Washington, D.C. Rest of article

Salary Study Update: Michigan Pathologists in 2017 by Mick Raich, Vachette Pathology, posted 14 June 2017
Earlier this year, we published a white paper that included breakouts in all of the major financial categories for pathologists across the nation based on our client data. We've since decided to crunch the numbers a bit further to provide an idea of what the average salary is for a pathologist in Michigan. Rest of article

Missed Appeals, MUE Denials And More In Vachette's Latest Audit Roundup by Mick Raich, Vachette Pathology, posted 31 May 2017
As we've continued to add new clients, Vachette's audit team has been hard at work uncovering and correcting a host of billing and compliance issues in an effort to put missing revenue back in our group's pockets. Here are some of our top findings from the first quarter of 2017. Rest of article

Check Your MIPS Status Online With New CMS Tool by Mick Raich, Vachette Pathology, posted 17 May 2017
While most clinicians should have received their Merit-based Incentive Payment System (MIPS) eligibility letters by now, CMS has also recently provided groups a way to check online whether or not they are required to participate in the new quality reporting program. Individuals can check whether they fall below the Medicare volume threshold ($30,000 or less in Medicare payments or seeing 100 or fewer Medicare patients) or qualify for another exemption. Rest of article


Coding Questions
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Thyroid FNA / 88172, 88177
Sentinel node biopsy / 88311, 88387-88388


Archive of All Articles
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Billing

Auditing your billing
Stories That Will Curl Your Hair Or Close To It!, by Michelle Miller, Vachette Pathology, posted 15 March 2011
The Basics of Auditing Your Pathology Billing (III), by Mick Raich, Vachette Pathology, posted 5May05
The Basics of Auditing Your Pathology Billing (II), by Mick Raich, Vachette Pathology, posted 5Jan05
The Basics of Auditing Your Pathology Billing (I), by Mick Raich, Vachette Pathology, posted 20Oct04

Billing-general
Lab Prior-Authorization Programs Continuing to Evolve by Mick Raich, Vachette Pathology, posted 9 August 2017
What Pathologists Can Expect from the 2018 Medicare Physician Fee Schedule by Mick Raich, Vachette Pathology, posted 26 July 2017
6 Highlights of the 2018 MIPS Proposed Rule by Mick Raich, Vachette Pathology, posted 17 July 2017
How Do You View The Pathology Recruitment Market? (Survey) by Mick Raich, Vachette Pathology, posted 28 June 2017
Salary Study Update: Michigan Pathologists in 2017 by Mick Raich, Vachette Pathology, posted 14 June 2017
Missed Appeals, MUE Denials And More In Vachette's Latest Audit Roundup by Mick Raich, Vachette Pathology, posted 31 May 2017
Check Your MIPS Status Online With New CMS Tool by Mick Raich, Vachette Pathology, posted 17 May 2017
Looking For A Registry To Assist With 2017 MIPS? Check Out The Full CMS List by Mick Raich, Vachette Pathology, posted 3 May 2017
Republicans Weighing AHCA Amendment by Mick Raich, Vachette Pathology, posted 19 April 2017
How To Identify PQRS Penalties by Mick Raich, Vachette Pathology, posted 22 Month 2017
Can Your Biller Help You Successfully Navigate MIPS? by Mick Raich, Vachette Pathology, posted 13 March 2017
Understanding the Benefits of Registry Reporting by Mick Raich, Vachette Pathology, posted 22 February 2017
Pathology Charges, Payments and Salary Trends in 2016 - White Paper by Mick Raich, Vachette Pathology, posted 8 February 2017
Commercial Insurers Aim To Lower Lab Reimbursements With Pre-Authorization Programs by Mick Raich, Vachette Pathology, posted 25 January 2017
Examining The Differences Between PQRS And MIPS by Mick Raich, Vachette Pathology, posted 11 January 2017
Looking For A Registry To Assist With MIPS? Check Out The Full CMS List! by Mick Raich, Vachette Pathology, posted 6 January 2017
Want To Avoid Medicare Penalties Under MACRA? by Mick Raich, Vachette Pathology, posted 28 December 2016
3 Tips To Improve Your Billing by AdvantEdge Healthcare Solutions (AHS), posted 15 December 2016
Navigating MUEs by Mick Raich, Vachette Pathology, posted 29 November 2016
Best Practices For Approaching Payer Audits by Mick Raich, Vachette Pathology, posted 15 November 2016
MACRA Final Rule Should Ease Providers' Fears For Now by Alex Mitchell, Vachette Pathology, posted 1 November 2016
Collection Agency's Blunder Leaves $565K In Limbo by Mick Raich, Vachette Pathology, posted 17 October 2016
How Pathologists Can Survive MIPS In 2017 by Mick Raich, Vachette Pathology, posted 28 September 2016
Several Pathology Codes Could See Significant Cuts Under Proposed Medicare Fee Schedule by Mick Raich, Vachette Pathology, posted 14 September 2016
PAMA Final Rule: What To Know And Who It Affects by Mick Raich, Vachette Pathology, posted 30 August 2016
A Quick Look At The 2017 Proposed Medicare Fee Schedule by Mick Raich, Vachette Pathology, posted 17 August 2016
Is Your Outdated Fee Schedule Leaving Money On The Table? by Mick Raich, Vachette Pathology, posted 3 August 2016
Revenue Changes For Health Care In 2016...So Far by Mick Raich, Vachette Pathology, posted 20 July 2016
Check Your Billing After A System Upgrade! by Angela Granlund, Vachette Pathology, posted 6 July 2016
Billers Fee Schedule Oversight A Costly One For Southern Pathology Lab by Mick Raich, Vachette Pathology, posted 20 June 2016
How Offshore Billing Services Will Impact Your Practice's Bottom Line by Cody Raich, Vachette Pathology, posted 25 May 2016
Preparing for the Merit-Based Incentive Payment System, by Alex Mitchell, Vachette Pathology, posted 11 May 2016
How CMS Plans to Save the Equivalent of Mongolia's GDP on Pathology, by Mick Raich, Vachette Pathology, posted 10 November 2015
Medicare Learning Network Update: New & Revised Codes for Outpatient Hospitals, by John Berry, Vachette Pathology, posted 27 October 2015
ICD-10 Is Here for Pathology, by Bill Gilbert, Vice President of Marketing, AdvantEdge Healthcare Solutions (AHS), posted 16 October 2015
The Wrath of the Titans Falls on Physicians and Consumers, by Jacob Vugrinac, Vachette Pathology, posted 13 October 2015
Good Old Rocky Top: Keeping its Physicians Independent, by Jacob Vugrinac, Vachette Pathology, posted 29 September 2015
An Overview of the New Proposed Medicare Fee Schedule, by Mick Raich, Vachette Pathology, posted 16 September 2015
Business Strategy for Pathology Practices and Independent Laboratories, by Mick Raich, Vachette Pathology, posted 3 August 2015
Billing Transition Issues Concerning Old Receivables, by Mick Raich, Vachette Pathology, posted 29 May 2015
Out-of-Network Labs, Pathologists May Have Some Recourse Against Insurers, by Mick Raich, Vachette Pathology, posted 15 May 2015
The Impact of H.R. 2 on Your Practice & What You Need to Do, by Mick Raich, Vachette Pathology, posted 1 May 2015
Business Strategy for Pathology Practices and Independent Laboratories, by Mick Raich, Vachette Pathology, posted 17 March 2015
New Business Model for Medical Billing Companies, by Mick Raich, Vachette Pathology, posted 22 October 2014
The Warning Signs of a Failing Billing Company or Revenue Cycle Management Firm, by Mick Raich, Vachette Pathology, posted 8 May 2014
Part A and Medical Directorship Contracts, by Mick Raich, Vachette Pathology, posted 28 April 2014
Sample Impact Analysis for the 88342 / G0461 changes by Mick Raich, Vachette Pathology, posted 8 January 2014
Ten Ways to Improve Your Requisitions, by Leigh Polk, McKesson Revenue Management Solutions, posted 11 October 2013
Thoughts on the Proposed Medicare Fee Schedule, by Mick Raich, Vachette Pathology, posted 2 August 2013
Commercial Insurance Plans following the Technical Component (TC) Grandfather Changes, by Mick Raich, Vachette Pathology, posted 21 May 2013
Could This Be the End of Insourced Pathology Billing? by Mick Raich, Vachette Pathology, posted 25 February 2013
A Managed Care Contracting Plan for Independent / Outreach Labs, Or How to stay profitable even if Medicare cuts your rates - Part One, by Mick Raich, Vachette Pathology, posted 15 January 2013
Locum Tenens - Applying it Correctly, by John R. Outlaw, CHC, CHBME, PSA, LLC, posted 12 December 2012
Changes in the Anatomic Pathology Billing World, by Mick Raich, President, Vachette Pathology, posted 14 November 2012
Missing Accession Audit Process, by Diana Brooks, PSA, LLC, posted 14 November 2012
Thoughts for the New Year (2012), by Mick Raich, Vachette Pathology, posted 26 January 2012
How to Gain a Better Managed Care Contract for your Independent Laboratory, by Mick Raich, Vachette Pathology, posted 9 September 2011
1993 Medicaid Reform Comes to Florida, by Mick Raich, Vachette Pathology, posted 1 April 2011
10 Questions to Ask Your Prospective Billing Company, by by Diana R. Brooks, PSA, posted 22 November 2010
Revenue as a By-Product of Investment: 6 Factors to Consider When Researching Billing Companies, by Diana R. Brooks, PSA, posted 12 November 2010
Changing Billing Services, by Mick Raich, Vachette Pathology, posted 28Aug10
Pathology Practices: Are Your Payers Paying You Correctly? Are You Sure? Can You Prove It?, by Al H. Sirmon and Stephanie Denham, PSA, posted 3Jun10
How to Utilize Your Billing Reports to Maintain and Grow Market Share. by Leigh Polk, PSA LLC, posted 24Apr10
Another Pay Cut for Pathology Practices and Laboratories, by Mick Raich, Vachette Pathology, posted 15Feb10
Payor Relationship Management Strategies and Trends: A Revenue Cycle Management Perspective, by Leigh Polk, PSA, LLC, posted 31Jan10
Underpayment of Pathology Technical Component, by Mick Raich, Vachette Pathology, posted 20Jan10
How the New Anti-Markup Rules May Change Your Practice, by Michelle Miller and Mick Raich, Vachette Pathology, posted 15May09
Billing Contracts verses Managed Care Contracts, by Mick Raich, Vachette Pathology, posted 20Apr09
The New Year Offerings, by Mick Raich, Vachette Pathology, posted 9Mar09
The Tangled Web of Claim Payments - How Managed Care Contracts Kill Your Revenue, by Mick Raich, Vachette Pathology, posted 4Nov08
Pathology takes another pay cut, by Mick Raich, Vachette Pathology, posted 24Oct08
Collaborative Labs and the Underlying Cost to Pathologists, by Mick Raich, Vachette Pathology, posted 3Sep08
Congress Delays Fee Schedule Cuts 6 Months - Or Not?, by John R. Outlaw, PSA, LLC, posted 1Apr08
Pathology Practice Management Issues for 2008, by Mick Raich, Vachette Pathology, posted 13Jan08
Pricing for Pathology Billing (part 2), by Mick Raich, Vachette Pathology, posted 19Apr07
Pricing for Pathology Billing (part 1), by Mick Raich, Vachette Pathology, posted 5Feb07
A Case Study in Increasing Practice Revenue through Managed Care Negotiations, by Mick Raich, Vachette Pathology, posted 24Jul06
Considerations for Outsourcing Billing Operations, by Pathology Service Associates, LLC, posted 31May06
Critical Strategies for Negotiating Contracts, by Mark S. Daniels, Audit Quality Inc., posted 4May06
Managed Care Payment Shopping, by Mick Raich, Vachette Pathology, posted 23Mar06
What Two Factors Are Critical to Maximizing Revenue?, by Mark S. Daniels and Ken Brodeur, Audit Quality Inc., posted 14Dec05
Are You Using Your Monthly Billing And Collection Reports Effectively by Al Sirmon, CPA, CEO, Pathology Service Associates, LLC, posted 3Nov04

Compliance
Five Simple Steps to Help You Avoid Audit Headaches, by Chappy Manning, PSA, LLC, posted 25 February 2011
The Case for Compliance: Why You Need an Effective Compliance Program, by John R. Outlaw, CHC, Chief Compliance Officer, PSA, posted 13Feb07

Direct billing / POD labs
Dèjà vu all Over Again, by Mick Raich, Vachette Pathology, posted 16 March 2011
CMS Continues to Tinker with Anti-Markup Rule, POD Labs and In-Office Histology Labs in the Cross-Hairs, by John Outlaw, PSA, LLC, posted 15Apr09
9.30.2005 - AP Day of Infamy, by Bernie Ness, B J Ness Consulting Group, LLC, posted 17Oct05
The Paradigm Shift in Pathology, by Bernie Ness, B J Ness Consulting Group, LLC, posted 10Mar05
To Bill or Not to Bill, That is The Question (Direct Billing), by Bernie Ness, B J Ness Consulting Group, LLC, posted 26Oct04


Other

Affordable Care Act (Obamacare)
Trump And Clinton On Health Care: The Status Quo Vs. An Undefined Vision, by Alex Mitchell, Vachette Pathology, posted 8 June 2016
The Health Insurance Marketplace and What The Health Exchange Plans Mean for Your Practice, by Ann Lambrix and Mick Raich, Vachette Practice Management / Stark Medical Auditing, posted 28 February 2014

Management - general
ACO's, Practice Buy-outs and Dèjà vu All over Again, by Mick Raich, Vachette Pathology, posted 9 July 2012
Hospital Outreach Laboratory For Sale. Who's Buying Now? by Mick Raich, Vachette Pathology, posted 30Nov08

Marketing
Strategies for Growing the Independent Pathology Practice, by Lisa A. Gryscavage, Vachette Pathology Services, posted 29Aug05
We Don't Need Any Sales Representation, Do We? by Bernie Ness, B J Ness Consulting Group, LLC, posted 13Dec04

Pathologist salaries
Pathology Salaries and the Big Picture, by Mick Raich, Vachette Pathology, posted 6 December 2010


Management Chapter - Anatomic Pathology Practices
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See also Computer Systems-AP/LIS

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