MLO - Medical Laboratory Observer

📊 Proficiency testing questions?

MLO’s popular “Dear API Abby” column is back with practical guidance on PT enrollment requirements, reinstatement testing, and how to stay on track with regulators.

👉 Read the latest installment—exclusively on our website—and submit your PT questions to [email protected]
API Abby returns in April.

https://bit.ly/4asKGGz?

Dear API Abby Dear API Abby, I received a notice from my accreditation agency that I am not enrolled in all the proficiency testing I need. I am enrolled for all the tests we perform in the...

Claims denials tied to laboratory testing aren’t just frustrating—they’re quietly draining revenue across the industry.

In this MLO online exclusive Q&A, Roshan Patel, Founder & CEO of Arrow unpacks why lab claims are being denied and where labs are most often caught off guard with MLO Editor-in-Chief, Christina Wichmann.

One key takeaway?
Most denials don’t stem from bad testing—they come from breakdowns in the basics:

- Missing or mismatched diagnosis codes

- Medical necessity rules that changed without warning

- Incomplete or inconsistent ordering information

- When those small issues repeat at scale, revenue leaks add up fast.

The conversation also explores how staffing shortages and rising test volumes are forcing labs to rethink the revenue cycle—and why smarter automation isn’t about replacing billing teams, but helping them see patterns sooner, prioritize risk, and prevent denials before they happen.

💡 The result:
Fewer claims in limbo, faster resolution, and a billing experience that feels clearer—not frustrating—for patients.

👉 Read the full Q&A to learn how laboratories can protect revenue while delivering a more patient-friendly testing experience: https://bit.ly/3YLKjjV.

Navigating lab claim denials: strategies to minimize revenue loss An interview with Roshan Patel

Will 2026 bring relief—or more uncertainty—for clinical laboratory reimbursement?

That question took center stage during a January 8 House Energy & Commerce Subcommittee hearing on Medicare payment policy and the proposed RESULTS Act.

Testimony from ACLA highlighted why many labs say the current PAMA framework isn’t working: outdated data, ongoing reimbursement cuts, and a reporting burden that pulls focus from patient care. Since 2018, Medicare lab payments have been reduced far beyond original projections—and more cuts are looming.

The RESULTS Act aims to change course by:
• Using broader, more current commercial market data
• Easing reporting requirements for most labs
• Freezing CLFS rates temporarily to stabilize the system
• Capping future payment reductions

In this MLO update, Editor-in-Chief Christina Wichmann outlines what happened at the hearing, what’s in the legislation, and why another short-term PAMA delay is likely before long-term reform takes hold.

🔗 Get the full breakdown: https://bit.ly/4sI64iq

Lab reimbursement update The House Energy and Commerce Subcommittee on Health held a hearing January 8th  to discuss legislation on Medicare payment policies and services for seniors, including...