PAMA Lab Test Private Payor Rate Reporting

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PAMA Lab Test Private Payor Rate Reporting
What clinical labs need to know NOW to avoid future penalties.

Protecting Access to Medicare Act (PAMA) requires applicable laboratories to report private payer rates for clinical laboratory services to the CMS; the data is necessary to calculate Medicare reimbursement rates for tests on the clinical laboratory fee schedule. In 2018, CMS included hospital “outreach” laboratories which submit claims for non-patient services to the list of entities that must report private payor data (if the hospital did more than $12,500 in specimen-only business with Medicare.)

While not all hospitals are required to report, failure to report (or incomplete, inaccurate reporting) may trigger significant financial penalties. Is your hospital required to report? Find out now in order to avoid penalties for next report of private payor rates, due first quarter of 2023.

Hospital laboratories could face considerable risk if not compliant with the latest PAMA requirements. Reporting inaccurate information could result in continuing downward adjustments to the Clinical Laboratory Fee Schedule — carrying far-reaching budget implications for hospitals, physician practices, and independent laboratories.

This informative webinar with an interactive Q&A session is a must-attend event for everyone in your hospital and lab team responsible for gathering, analyzing, and reporting data to CMS. You’ll get answers to your toughest questions and master the knowledge you need to report accurate and complete data on time.

Wednesday, May 11 from 11:00am – 12:00pm


Learning Objectives:
At the conclusion of the webinar attendees will be able to:

  • Comprehend the CMS’ mandate for Lab PAMA reporting – who, what, why, and when
  • Recognize whether your hospital is required to report at all
  • Evaluate the organizational ability to collect and calculate the required data
  • Anticipate the consequences are for failure to report timely, accurate, and complete private payor data to CMS within the required reporting period.

Who should attend the webinar?
Hospital CEOs, CIOs, finance managers, revenue integrity managers, billing managers, patient financial services staff, compliance officers, and laboratory directors.

As a division of the South Carolina Hospital Association, we understand the hospital business. Our ready-to-deploy solutions for your workforce, financial, operational and compliance needs can save money on your bottom line – or generate revenue that you can re-invest in improving healthcare for the people of South Carolina.  For more information, visit Solvent Networks, follow us on Linked In or watch HERE.  Access your network today.

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