Author Topic: New Lab with Questions  (Read 2222 times)

diagnostico

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New Lab with Questions
« on: March 30, 2013, 02:40:51 PM »
Hi everyone,
we have just received our CLIA approval and currently only process urine. We are looking to expand our offering and are looking to perform tests with higher reimbursement rates for Workmen's Comp and PIP. Can you please recommend other tests that have reasonably high reimbursement rates for WC and PIP? We want to start off as profitable as possible.
Thanks very much for your help.

RichardP

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Re: New Lab with Questions
« Reply #1 on: March 30, 2013, 03:38:25 PM »
Hello again.  There are several type of lab certifications.  The work your lab is allowed to do depends on what certification you have for the lab.  Just out of curiousity, do you know what type of certification your lab has?

CLIA regulations are based on the complexity of the test method. Test methods are categorized into three levels of complexity:

Waived Complexity;

Moderate Complexity, including Provider-Performed Microscopy Procedures (PPMP); and

High Complexity.

The more complicated the test, the more stringent the requirements. CLIA specifies quality standards for PT, facility administration, general laboratory systems, preanalytic, analytic, and postanalytic systems, personnel qualifications and responsi-bilities, quality control, quality assessment, and specific cytology provisions for laboratories performing moderate and/or high complexity tests.


From here:

http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/CLIABrochure.pdf

We don't do much Workmen's Comp, but the work we do is paid at the Medicare rate for Southern California.  If you don't already have the 2013 Clinical Laboratory Fee Schedule for your Region, you can find it at the following link.  Scroll down to the Related Links heading and click on 13CLAB .  You will get the AMA User Agreement.  Scroll down and click on Accept.  That will give you a Zip file to download.  When you open the Zip file you will find CLAB2013.cvs, CLAB2013.txt, and CLAB2013.xlsx.  The *.cvs file will automatically open as a spreadsheet in Excel when you double-click on it.  The *.xlsx file will automatically open as a spreadsheet in Excel when you double-click on it ONLY if you have a version of Excel higher than either 2007 or 2009 (don't remember which).  If you need to open the *.xlsx file and cannot, either OpenOffice or LibreOffice will open it - both links follow the CMS link.  You will need to scroll across and look at the Column Headings to find the column of prices for your CMS Region.  If you already know all of this, then nevermind.

http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ClinicalLabFeeSched/clinlab.html

http://www.openoffice.org/

http://www.libreoffice.org/
« Last Edit: March 31, 2013, 05:54:59 PM by RichardP »

diagnostico

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Re: New Lab with Questions
« Reply #2 on: April 10, 2013, 10:42:44 PM »
RichardP,
Thanks again. I can always count on you.

Medical Billing Forum

Re: New Lab with Questions
« Reply #2 on: April 10, 2013, 10:42:44 PM »