EKRA- New Law Regarding Billing

New law, effective October, 2018 dictates ALL LABORATORIES must balance bill. No more "special manager pricing "..that's to you Cleveland. Criminal charges. Your client's patients will be back billed the full amount not covered by insurance if you continue to ignore this law. You are PUTTING YOUR JOB A RISK BY IGNORING THIS LAW.

 

bye bye Cleveland Heartlab!

 

This law says that
NO COMMISSION is allowed at all, whatsoever in lab.

Ask if anyone will tell you the truth about that.

 

are you saying the reps for Cleveland clinics won’t get paid commission?

 

Corruption is caused by individual state rules ASSHOLE

 

CLEVELAND HEART HAS TO BILL TO EOB ...PERIOD.

 

This means that anyone getting a bonus based in any part on volume of testing, profits, etc would be illegal. The one and ONLY way to legally pay a rep according to this new lab would be a salary and if you give a bonus it could not in any way be tied to sales.

 

hopefully Cleveland clinics are taken out of growth #’s for the reps

 

Has this been discussed at all by leadership? As stated above, it says reps can’t be paid according to volume/billing/profits...then what the hell are we doing?

 

Yes.

It is being reviewed. It just came out, and will be discussed for 2019 comp may be delayed.

But that’s every year

 

We have known about this well before the release and have already been transitioning to a marketing vs sales approach. Physician account sales and traditional reps will soon be a thing of the past. Our true customers are and always have been the patients and their insurance carriers. Selling our services to the ordering physicians has always been a corrupt practice that the leadership finds distasteful. The individual consumer should always decide if a test should be performed, and by what entity. If you want to continue selling lab testing services while bypassing the actual customer, I suggest you contact Antech or Idexx with a current resume. Hope this helps.

 

“The individual consumer should always decide if a test should be performed” ???

If that’s the case, why even bother going to a doctor? Just decide what tests you need and diagnose yourself. Great idea. You are upper management material.

 

You customers are the insurance carriers. Patients hate your lab an only use it because insurers tell them tehy have to. If it was a true free market and every lab was in network with all insurances Quest and Labcorp would be about $1b is revenue. You both suck at actually providing lab services. The corrupt practices are how Labcorp and Quest pay off insurance companies to get their business.

 

Get Answers. Get Healthy.
With QuestDirect, you can get the information you need to support a healthy life – for yourself. Conveniently shop online and choose your own lab tests. Get most results in less than a week.

Hope this helps

 

Were you aware of the fact that it is the insurance companies who pay us, which is why they and their members are the customers. The physicians are separate providers who are also compensated by the patients and their insurance. What would be the point for us, to pay the insurance, to pay us? Insurance companies contract with us because of the low cost, high quality service that we provide. We call that value, son. Welcome to the actual free market. Sorry you came up short in that deal. Hope this helps

 

Low cost is correct, high quality is another issue. You are a conveyor belt lab with, zero customer service and your quality sucks. You pay off the insurers by giving them below cost capitation rates, low fee for service on basic testing and then you kill the insurers by up selling to unnecessary esoteric tests (genetic, specialty heart, etc). More an more insurers are catching on to this and letting more labs in-network. You only win because you guys are the Dollar Store of labs. Cheap, but crappy. A free market is not lowering your price to stamp out competition. A free market is letting everyone in to play and see who comes out the winner. Quest and Labcorp would be $6b losers if everyone was let in. You guys suck, you know it and you win by being cheap. I was on a call with an insurer that uses Quest and said to them that we can give them better service, faster result turn around, utilization files, and much more. The response from the insurer was "We don't care about quality, we only care about price" You guys have sold the insurers a bill of goods. Price is all that matters and you know it!

 

One more thing, the members of that particular insurance do not have a choice for labs. Their company pays for the insurance (no choice to employee) and the insurance company tells them what lab to go to. Don't play games with me. I have been around this business for over 40 years, still make a damn good living, am my own boss and I am taking market share in my region from both Quest and Labcorp due to insurers allowing my lab in-network. That is why in the 2018 I have gotten 3 calls each from the big 2 trying to buy my lab. I will not sell, because I know they are afraid. I am getting too big and intruding on their territory. They do not like that because they know they can't compete in a fair playing field. As a sales rep you have no idea what the higher ups at your company are doing. They try to buy every labs that gets over $75m because they are a threat.

 

If by some chance you actually are a lab owner, as you say, then I would suggest that you spend less time on the Quest CP board and more time producing and pricing your services appropriately, to meet the market demand. And if you provide a health insurance benefit for your employees, try picking a plan without network restrictions, if it is of such importance. Otherwise, individuals always have the choice to purchase their own insurance or pay more for out of network services. The free market always sorts things out, and I’m guessing it will for you very soon as well. Hope this helps.

 

What a crock of shit numbnuts, stop bloviating, I can assure you that the big 2 don't fear you or anyone for that matter. There is not a lab out there growing organically at the rate you claim, so wkae up from your dream.

 

BH from Labcorp was at my lab last month trying to bring us to the negotiating table. Don't tell me about my organic growth. I didn't even mention what it is. But if you must know our organic growth was over 25% in 2018, up from 22% in 2017. You are also wrong about the big 2 not fearing smaller labs. They do! They read the smaller labs because they know if a lab gets too big, the jump to take even greater regional market share from Q & L is not a big one. It then snowballs to a more super regional level and then national. In the old days it was hard to do this, but now it is easier. United, Aetna, Cigna, & Most Blues are letting my lab in as a full in-network lab. We are only a regional lab, so they let us in. If we were national they would not. We are in on a State by State basis. You have no idea what you are talking about. The days of Q & L being the only in network labs is going away. I even have contracts with State Medicaid Managed Care now. 10 years ago we would not be let in. The insurers are on to the upsell Q & L perpetrate on the insurers. They know they get a good deal on basic testing and get corn holed on the upsell test. I had 1 company give me a contract after the lab spend for Q went up 30% in 2017 even though the population of the insurer increased on 1%. The increase was from the upsell. They kept Q in but no we have 47% of that insurers work. Q is freaking out. So don;t tell me I am dreaming. Who is the numbnuts now!