In This Issue:



• New webinar on opening payer networks for labs
• Managing risk assessment in toxicology testing
• 2026 Alternative Proficiency Testing reminder
• Exploring the post-COVID lab growth
• Anthem policy change set to impact labs and hospitals
• New strategic partnership

Upcoming Webinar: Lab Network Access Challenges - A National Strategy to Open Closed Payer Networks

Getting in-network with payers shouldn’t require insider connections, legal action, or endless resubmissions. But for many independent labs, that’s unfortunately the reality.

Join us at Noon EST, Tuesday, Nov. 18, 2025, as Dr. Sherry Dadgar and Lighthouse's Ann Lambrix break down:

• Why payer networks remain closed to independent labs
• Strategies to strengthen your contracting position
• A developing nationwide effort to secure access in all 50 states

If payer access has held your lab back or continues to negatively impact your reimbursement, this is a conversation you don’t want to miss.

REGISTER HERE

How MolDx and DEX Are Impacting Molecular Testing Reimbursement

When discussing reimbursement for molecular testing, terms like MolDx, DEX, and other payer programs, it can be difficult to decipher how they interact with one another. 

If you missed our recent webinar, more than 480 lab decision-makers and stakeholders joined live to learn about the current state of these programs and how reimbursement may evolve in the near future. Check out this quick primer with Ann Lambrix as she explains the difference between MolDx and DEX in 60 seconds!

Big thanks again to everyone who joined yesterday! If you didn't get a chance to register, the full recording is now available on YouTube.

Watch HERE>

Sequencing, Proprietary Assays, and Infectious Disease MDx Drive Clinical Lab Growth Post-COVID

In a recent interview with 360Dx, Lighthouse Lab Services President & CRO Ellen Beasusang weighed in on the most significant areas of growth for labs in the post-COVID years. One area highlighted by Beausang was the expansion of molecular infectious disease testing, which Medicare payment data shows has experienced significant growth.

"Labs are really trying to focus on where there is transferability from a COVID platform to another disease state where they can use the same technology, and it's usually infectious disease," Beausang said, citing urinary tract infections and STIs as strong growth areas.

Read the full interview HERE (subscription required)>

Balancing Compliance, Risk, & Revenue in Toxicology Testing

Many labs focus solely on whether they have an order for testing, but that’s only one piece of the puzzle. When labs are audited, payers want to see a clear story: Why was the test ordered, was it performed, and how was it used?

From a legal and clinical perspective, patient harm risk must remain central. Malpractice exposure rises when testing is inadequate or test results are not reviewed and incorporated into care plans. That’s why complete documentation matters even when you anticipate limited coverage.

“We’re not just worried about getting paid: what are the consequences of a failure to test or to adequately test?” notes Dr. Michael Sprintz, CEO & Founder of Cellarian.

Check out the full guide and risk assessment worksheet HERE>

Secure Alternative Proficiency Testing Samples for 2026

Our Alternative Split Sample Assessment Program gives your lab direct access to a curated menu of toxicology and ethanol analytes, providing an ideal way to meet 2026 CLIA proficiency testing requirements without relying on multiple vendors.

Each survey includes two shipments per year, with all testing materials delivered directly to your lab:

• Tox (Urine): includes extensive drug class coverage.
• Ethanol (Urine): qualitative and quantitative options.
• Shipping dates: April 21 and Sept.15, 2026.

View the full analyte panel & order form (PDF) or reply to this email to request samples and full pricing.

The Lighthouse "Candidate Corner" is a recurring monthly spotlight featuring some of the great lab professionals our recruiters work with each day. Check out a quick preview of one individual below, then click over to our blog to see all five candidates for November.

If you'd like to learn more about anyone listed in this section or inquire about their ability to relocate, email us directly here!

Candidate: Director of Lab Operations

• Education: 
• MS Biotechnology/BS Biotechnology, Chemistry, Microbiology

• Certification:
• MB(ASCP)

• Preferred Location:
• Any location

View all candidates HERE>

Anthem Policy Change to Impact Labs Beginning Jan. 1, 2026

Anthem has issued a new policy that could directly affect pathology groups and independent laboratories who are not participating in their network.

Effective January 1, 2026, Anthem will penalize facilities 10% of the amount of the facility’s claims if the claim involves a non-participating provider (e.g., an out-of-network pathology group or lab). Continued use of non-participating providers may also put a facility at risk of network termination.

Impact:

• Hospitals and facilities will push affiliated pathology groups and labs to participate with Anthem.
• Independent labs without an Anthem agreement may lose referrals or be forced out of consideration.
• Negotiation leverage with Anthem will continue to diminish.

Recommended actions for laboratories:

• Confirm whether Anthem is a large portion of your payer mix.
• Validate your participation status.
• If no agreement exists, begin developing a contracting strategy now.

Lighthouse Lab Services can help evaluate your participation risk, pursue payer agreements, and navigate potential opportunities under the No Surprises Act and other avenues. Reach out to us today to schedule a complimentary call.

We’re thrilled to share that Lighthouse has officially partnered with SYNERGEN Health, a leader in technology-enabled RCM services for healthcare organizations.

We believe receiving fair reimbursements shouldn’t be the hardest part of running a lab. Through this collaboration, labs working with Lighthouse will have access to SYNERGEN’s lab-specific RCM platform, combining expert billing support, optimized workflows, and AI-driven insights to reduce denials and speed up reimbursements.

"With continued challenges that plague a lab's revenue cycle, Lighthouse strives to partner with best-in-class platforms that will support our clients' success." — Ann Lambrix, Executive Director of RCM Consulting

Together, we’re giving labs the tools and support they need to stay financially strong and focus on delivering high-quality diagnostics.

Read the full press release HERE>

AAPS PharmSci 360

• Nov. 9-12, 2025
• San Antonio, TX.
• Booth #4028
• Learn more here

Q1 Diagnostic Coverage and Reimbursement Conference

• Dec. 9-10, 2025
• Boston, MA.
• Learn more here

This email is brought to you as a service from Lighthouse Lab Services to provide quality and timely information that can improve your laboratory operations. We strive to maintain our position as the country’s premier lab consulting firm and support your success.