Profit and Labs


You are so full of crap trying to say that OON has almost 100% deductibles. I agree that reps should not be saying someone will NOT get a bill. You are legally REQUIRED to bill at least 3 times.

You are NOT required to send the patient to collections espically if you are OON.
HOWEVER, if you are In-Network you can count on the fact that the contract that the insurance carriers made the lab agree to and sign includes language that demands the lab collect the deductible and copay from the patients and that is set by the insurance carrier NOT the lab.

Insurance carriers do not give one lab the option not to collect with lab "A" and force Lab "B" to do so. Yes, most plans have high deductables for patients when they use OON providers and services HOWEVER most OON never send anyone to collections but I can guarantee you that both LabCorp and Quest will send you to collections over $5 because I worked there and know they do this.

I have seen tons of the HOPD models send patients big bills and they are In-Network too PLUS they usually harass the hell out of the patient over their bill and that's because they HAVE to otherwise the insurance carriers will cancel their contract and that's with ALL In-Network Labs.

What I meant by OON is almost 100% deductible is that almost 100% of OON claims have some type of deductible. Also the OIG has guidance on billing co-pays and deductibles. You are allowed to write off about 20% of the the charges. After that it is considered a kickback. All you morons on this site need to do your homework. I came up through billing and then transitioned to sales. You sales reps are idiots. OON is dead! Audits are happening by Medicare more and more. My lab just had an audit and we only paid back 3% of claims. That is outstanding. Lawyers I know in tell me most tox labs are getting dinged for 60-75% of claims. I can't wait until you are all out of business.

Love, The Loser!
 

What I meant by OON is almost 100% deductible is that almost 100% of OON claims have some type of deductible. Also the OIG has guidance on billing co-pays and deductibles. You are allowed to write off about 20% of the the charges. After that it is considered a kickback. All you morons on this site need to do your homework. I came up through billing and then transitioned to sales. You sales reps are idiots. OON is dead! Audits are happening by Medicare more and more. My lab just had an audit and we only paid back 3% of claims. That is outstanding. Lawyers I know in tell me most tox labs are getting dinged for 60-75% of claims. I can't wait until you are all out of business.

Love, The Loser!

I call total and complete BS on that number of 60%-75% payback on an audit. I would estimate that 90% of labs would file for bankruptcy if they got hit for that much and while there are plenty of labs failing the dropout rate is not nearly that high.
You are also way off base on OON because for 95% of americans they have a deductiable regardless of whether they use an OON or In-Network lab. You are also totally wrong about OON being dead because if you know what you are doing it is still GREAT money. I think we all find it rather ironic that you say "you sales reps" when you are one yourself. Feel free to call yourself arrogant and stupid if you want but my reps and my lab are laughing all the way to the bank.
 
I call total and complete BS on that number of 60%-75% payback on an audit. I would estimate that 90% of labs would file for bankruptcy if they got hit for that much and while there are plenty of labs failing the dropout rate is not nearly that high.
You are also way off base on OON because for 95% of americans they have a deductiable regardless of whether they use an OON or In-Network lab. You are also totally wrong about OON being dead because if you know what you are doing it is still GREAT money. I think we all find it rather ironic that you say "you sales reps" when you are one yourself. Feel free to call yourself arrogant and stupid if you want but my reps and my lab are laughing all the way to the bank.

Typical 1099 BS. You aren't making any money. When the Feds come for, which they will. Let's see how much you are laughing at that point. I hope you like orange jumpsuits, you will be in one soon enough.
 
I call total and complete BS on that number of 60%-75% payback on an audit. I would estimate that 90% of labs would file for bankruptcy if they got hit for that much and while there are plenty of labs failing the dropout rate is not nearly that high.
You are also way off base on OON because for 95% of americans they have a deductiable regardless of whether they use an OON or In-Network lab. You are also totally wrong about OON being dead because if you know what you are doing it is still GREAT money. I think we all find it rather ironic that you say "you sales reps" when you are one yourself. Feel free to call yourself arrogant and stupid if you want but my reps and my lab are laughing all the way to the bank.

I am not just a sales rep you idiot. I am also part owner that actual sees the financials of the company. I am not some 1099 like you who thinks all labs are making tons of money. The OON is good money if you get paid. Most labs only get paid on 40% of the OON claims, the rest they chase the patient to pay. In 2018 watch this number fall to 20% of claims. I am IN with 99% of our the plans we bill. I used to work for the insurance companies and have high level contacts. You have no idea what you are talking about. As to the 60%-75% claims payback on audits, there are labs filing bankruptcy you idiot. This number is true and only getting worse. What you have to realize is CMS wants to stop paying for PGS, Genetics and Tox. They want to pay $20 for a screen and $80 for a confirm. The people on this board have not idea what is coming. You need to bill full service or have an exclusive test that is approved or you will be out of business. Stop arguing with me and wake the F**K up you idiots. 2018 is going to be a sh*t storm if you are not prepared. My lab is prepared. Obviously you and your lab(s) are not!
 
I am not just a sales rep you idiot. I am also part owner that actual sees the financials of the company. I am not some 1099 like you who thinks all labs are making tons of money. The OON is good money if you get paid. Most labs only get paid on 40% of the OON claims, the rest they chase the patient to pay. In 2018 watch this number fall to 20% of claims. I am IN with 99% of our the plans we bill. I used to work for the insurance companies and have high level contacts. You have no idea what you are talking about. As to the 60%-75% claims payback on audits, there are labs filing bankruptcy you idiot. This number is true and only getting worse. What you have to realize is CMS wants to stop paying for PGS, Genetics and Tox. They want to pay $20 for a screen and $80 for a confirm. The people on this board have not idea what is coming. You need to bill full service or have an exclusive test that is approved or you will be out of business. Stop arguing with me and wake the F**K up you idiots. 2018 is going to be a sh*t storm if you are not prepared. My lab is prepared. Obviously you and your lab(s) are not!

I call BS. Show some proof!
 
Big pharma won't take you back once they understand you were a tox scum bucket. They will know you are a scammer, no morals or values, and swam in a pool of 1099 losers like yourself. Good luck getting your catering job back.

Work 30-35 hrs a week (if that) and make 138k a yr, plus car, plus, plus, plus...
Never drive more than an hour, talk to actual doctors and not bottom feeding ma's and office mngrs...
Sell products that people have actually heard of and want...
I'll gladly run to big pharma, any day
 
I am not just a sales rep you idiot. I am also part owner that actual sees the financials of the company. I am not some 1099 like you who thinks all labs are making tons of money. The OON is good money if you get paid. Most labs only get paid on 40% of the OON claims, the rest they chase the patient to pay. In 2018 watch this number fall to 20% of claims. I am IN with 99% of our the plans we bill. I used to work for the insurance companies and have high level contacts. You have no idea what you are talking about. As to the 60%-75% claims payback on audits, there are labs filing bankruptcy you idiot. This number is true and only getting worse. What you have to realize is CMS wants to stop paying for PGS, Genetics and Tox. They want to pay $20 for a screen and $80 for a confirm. The people on this board have not idea what is coming. You need to bill full service or have an exclusive test that is approved or you will be out of business. Stop arguing with me and wake the F**K up you idiots. 2018 is going to be a sh*t storm if you are not prepared. My lab is prepared. Obviously you and your lab(s) are not!

I don't see CMS paying just $80 for a confirm Mr. All Knowing and it is almost 2019 now. Also CMS still pays for PGx. Can we all say someone once had a job screaming the sky is falling, the sky is falling!
 


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