Sunday, July 28, 2024 1:30 PM – 4:30 PM US Central Time McCormick Place Chicago
Fair payment for laboratory tests and protection for patients against excessive laboratory bills are both foundational to a laboratory’s success. There is a surprising lack of general knowledge among large groups of laboratorians, from leaders through trainees, regarding the basic functioning and challenges of the fee-for-service system for test payment in the United States. This knowledge gap leads to a range of laboratory financial problems from low profitability to massive financial losses. In this course, the laboratory payment system is described including the costing and pricing of a test; the coding and submission of an insurance claim; the administrative and medical necessity policies used by insurers (private or government) to accept or deny a claim; and the administrative rules determining the payment of claims by insurers and patients. The course material is taught using a combination of lectures, audience polling, and short small-group exercises.
This activity is designed for physicians, advanced practice professionals (NPs, PAs, RNs, etc.), lab directors (and/or assistant directors), lab managers (supervisory and/or non-supervisory), pathologists, in-training individuals, and other laboratory professionals overseeing/conducting within this topic.
General knowledge regarding the following items will be helpful, but not required:
A fully-charged personal laptop with Microsoft Excel and an Internet browser could be helpful, but not required.
Michael Astion, MD, PhD | Seattle Children's Hospital
Nikola Baumann, PhD, DABCC | Mayo Clinic
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