In Search for In Network Tox Lab???

They are, but the legit labs in the tox space will keep their contracts. They won't stay in business long under the cuts, but they'll have in-network status.

 

Sure. Email me. Or call me. Here is my resume. Lets me at this location.

 

Any updates on the labs with legitimate in network contracts? Or National Contracts?

Also, how does it work when a lab says they have a national contract with BCBS but only have the contract for the lab state? Can someone explain that difference? I am a rep in Tennessee and want BCBS of Tennessee, but the lab is located in Texas or California and they have the Anthem/BCBS contracts for TX & CA?

How does that work for my patients in Tennessee? Will those tests get reimbursed? Also, having a BCBS contract in your state does that qualify as a national contract?

REAL feedback would be appreciated. Thanks!

 

I'm not too sure about the difference, but I had a similar experience with a lab that had a state contract with BCBS and they told me that put them IN nationally. The patients weren't covered in the states I was in and they received OON bills.

 

Each state BCBS has their own lab network, and typically limit participation as much as possible.

Odds are they either gonna pay claims on a lab in Texas, and if they do, they'll waste no time threatening the offices.

 

Email me at sales [at] vetascientific [dot] com if you're looking for in-network BCBS, no HOPD or pass-through billing of any kind. If it's PPO BCBS, we have two labs in two different states that can bill it and can be paid, regardless of the state that receives the sample. Tox is averaging around $450-500 gross, then lab takes out COG and split comes afterward. Strict compliance protocol, but well worth it. Fast turnaround on payments too, as BCBS pays the lab between 10-14 days after they bill.

Lab has multiplan with United, so not incredible, but works. Aetna is actually pretty good as well, and Cigna is hit or miss as they've changed their regulations.

For those of you that don't believe me, it's fine. Won't expect your email...

 

Multiplan? Are you freaking kidding me? Multiplan is the worst of EVERYTHING. Multiplan is NOT In-Network nor does it pay half as good as just billing it OON so why would any rep want that?

 

Check out Vision Laboratories. They are in Chattanooga Tennessee and are in network with BCBS of TN.

 

Look up the website he said to email him, its not even real

 

Like many others on here, I know it can be extremely difficult to find not only an in network lab, but one that has a decent comp plan and pays their reps in a timely fashion. I have been searching for quite some time myself for the “holy grail” so to speak (joking). Basically, a normal compliant lab that will be around for the long term. Based on my research 95% of the labs I spoke with were either non compliant or OON labs. There are still a few good independent labs out there, so don’t give up hope! My search has finally come to an end. Anyone else have luck with a compliant in network lab that has high reimbursement rates and pays their reps in a timely fashion ie. not lab to lab, pass through billing, distributor, HOPD, lab owned hospital etc.

 

They don’t exist! Most of these “distributors” are ex compounding reps trying to relive the glory days of 2014 without much success!

 

The problem is that any lab that is IN will not have high reimbursement rates. Their rates will most likely be a % of Medicare (75% to as low as 40%). This is just a fact of life that you independent reps will not accept. You still want you $25 per sample or 30% commission rate. These deals are dying. If the reps would take a 10%-12% commission then you would probably get paid by the legitimate labs. Most labs also up bill to the 2nd or 3rd tier LC/MS/MS code even when it is not medically necessary. Find a legitimate lab, make about 150k per year ore find a new line of business. Everyone on here blames the criminal labs for the abuse, but all you 1099 reps are at fault too! Greed killed all of you and my lab is still making the same profits because our billing never changed. We just have lower margins with higher volume to make up for the lower rates.

 

This is so true. Greed put the lab industry on life support and now smaller labs are pulling the plug for the final death knell! Either accept a nice living or be greedy, do something illegal and then go to jail. I'll take my $150k and stay out of jail.

 

Evidently you aren’t in the business.

 

Wrong!

 

If you are billing OON then you may get 300% of medicare until they realize you are OON and put you on pre-payment review or just deny your claims. All IN insurers are paying a % of MCR CLFS- ranging from 40-45% for United to 75% for BC/BS. If you are getting more then you are either doing something illegal or are just lying. Even Quest and Labcorp site these rates. You are a fool and just looking to get samples to rip off the reps!

 

Don’t believe anyone who claims a lab has a blue that pays 300%. I own a clinical in network lab and my contracts range from 45%-75% of medicare. FYI there is no such thing as a super blue! Good luck, my advice: don’t be cocky or greedy. Owning a lab is not easy. Find a lab you can visit with.