Are you ready for PAMA?
The final sub-regulatory guidance, recently released by CMS, provides details on what laboratories must do to submit data, which data to submit, and in what format—to comply with PAMA reporting requirements.
January 1, 2017, the start of the reporting period, is just around the corner. So if you don’t know what’s required under the mandate, or you do, but don’t have the systems in place to collect this data, you could end up facing federal sanctions and paying significant penalties for failing to report or for reporting inaccurate information.
Under PAMA, “applicable laboratories” are required to submit data on private payer rates and associated volumes for covered tests. CMS will then use that information to create the 2018 clinical laboratory fee schedule (CLFS) payment rates.
So what does CMS mean by an “applicable laboratory”? How do you determine if your lab is an applicable lab? And what are the reporting requirements if you are?
Get answers to these questions and more when you purchase the CD of “How to Prepare Your Laboratory to Collect, Validate, and Report Accurate Data Under PAMA and Avoid Substantial Penalties” which originally aired on Wednesday, December 7, 2016. Listen as Charles Dunham and Wendy Baehne provide you with the tools you need to meet PAMA reporting requirements beginning January 1, 2017.
Find out how to determine whether your lab meets the definition of an applicable PAMA laboratory—and how to proceed if it does. You’ll get details about the internal systems you’ll need to create in your lab to collect, organize, analyze, and validate your data—and how to submit the information once you have it.
You’ll learn about the operational changes your lab may need to make to ensure that all the required data is collected. Find out which of your lab’s operational processes, from zero-pay remittance entry to appeals processing, could affect the way your remittance information is stored in your RCM system, and ultimately, how you gather and validate the data you report to CMS for PAMA.
You’ll also get details about the soon-to-be-released sub-regulatory guidance for labs that want to pursue advanced diagnostic laboratory test status (ADLT) for its genetic or molecular tests. You’ll learn what it takes to apply and be certified, and whether or not the benefits actually warrant going through the process in the first place.
Whether you’re a laboratory manager, pathologist, compliance officer, billing director—anyone who needs to be on top of PAMA reporting requirements to avoid federal sanctions and penalties—this is one webinar you don’t want to miss.
Charles Dunham is a business and healthcare-law attorney at Epstein Becker & Green, P.C. His national practice includes representation of healthcare providers and health-related entities, with a focus on clinical laboratories and pathology practices. He provides general counsel on corporate and health regulatory compliance, as well as transactional matters, including mergers, acquisitions and business ventures. Mr. Dunham also represents healthcare providers in government enforcement actions and commercial litigation.
Wendy Baehne is vice president, RCM at TELCOR, and has 20 years of experience in laboratory revenue cycle management (RCM). She is responsible for TELCOR RCM product management, which includes overseeing the software development lifecycle and ensuring the TELCOR solution is configured to meet the ever-changing needs of a dynamic healthcare industry.
Prior to joining TELCOR in 2007, Ms. Baehne was the interim director of finance for a clinical laboratory in east Texas. Her laboratory revenue cycle experience includes handling daily activities of managing claims, invoicing, and payment processing as well as system administration.