Mastering Medicare

Episode 8: Andy Diamond, President of Diamond Medical Labs and Mobile Medical Imaging, Part 1


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Amy and Alex interview Andy Diamond, the President of Diamond Medical Labs and Mobile Medical Imaging. In this amazing episode, Andy teaches us everything about how labs are done in nursing homes, rehabs, assisted livings and in patients' homes.

In part 1 we discuss:
How and why do lab companies have contracts with nursing homes and assisted living facilities?
Part A and Part B billing for labs in the same facility
Figuring out Same and Similar in the lab world
Patient financial responsibility for labs drawn in a nursing home
Lack of centralized database of lab data
Integration with state health information exchange / CRISP
What is a health information exchange?
Why does CRISP charge the lab company to participate?
Nursing home is paying for some lab tests directly
Lab billing denials
Revenue cycle management in the lab world
What are the most common mistakes and issues when nursing homes and assisted livings order labs?
What labs aren't allowed to tell ordering physicians?
Alex thinks the rules for ordering labs are stupid
Trends in lab testing
Molecular testing - why is molecular testing becoming more popular?
Who collects urine samples in nursing homes and homebound patients?
What is the cost of molecular testing and is the denial rate different?
What things to consider other than just the cost of a lab test?
Workflow requirements for molecular testing
PGX testing - what is it and why would you order it?
Cost of PGX testing
Are the results from PGX testing easy to interpret?
Effect of PAMA on labs and lookback for lab payments
Why doctors can't have their own labs

...more
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