Many physicians assume that between regulations and reimbursement, in-office laboratories are not worth the hassle. The good news is that the benefits often outnumber the drawbacks. Here are three good options for adding lab work to your service offering in your practice:
1. Set up a full-service CLIA-certified lab. Setting up an in-office lab comes with its fair share of regulations, you have all heard of Clinical Laboratory Improvement Amendments (CLIA), and the requirements can be daunting. If you elect to offer a full spectrum of in-office labs, then hiring an expert in setting up a CLIA-certified lab is important. There is of course investment expense in the equipment and the CLIA license and hiring the expert to come in, set up the lab, train your staff, and monitor your lab periodically after they have exited. Will it take some extra work? Yes, there will be additional staff time and expense and additional billing to manage, but in office labs can certainly pay off in the form of reimbursements for the lab fees.
A few of the tests that can be performed in an in-office lab (general practice and are eligible for reimbursement) include: basic metabolic panel, comprehensive metabolic panel, lipid panel, drug screen, urinalysis, albumin, colorectal screening, creatinine, lead, potassium, protein, some hemoglobin tests, influenza A or B, streptoccus, and nasal smears. There are even more for specialists.
2. Set up a CLIA-waived lab. There are many testing devices on the market today that allow physicians and their techs to perform instant lab tests in their office while operating as a “waived” lab. Operating as a CLIA waived lab can certainly be easier on the investment side of things, and often these tests require less skill from the techs because many of them are finger-stick tests.
Aside from the benefit of a smaller time and financial investment, CLIA-waived labs obviously have fewer regulations and requirements. Instant read tests are uber-convenient for patients.
You can find a complete listing of the approved instant tests (and where you can purchase them on the FDA website or by searching “CLIA Waived Tests.”
3. Source it out. If buying and managing the equipment, people, regulations, and reimbursement does not fit your vision or if you want to provide more in depth services to your patients, then contracting a lab to send your samples to is the way to go.
You are still providing better service for the patients, and some of these places have great complimentary services to go with their lab tests. One example is a company called Health Diagnostic Laboratories (HDL). HDL’s flagship service is its Advanced Lipid Testing (which I covered in last year’s revenue series here). This blood test checks for lipid markers that are very early indicators for a multitude of diseases from many different body functions. Over the last year, HDL has expanded their clinical offering to include Omega 3 Index, MTHFR gene testing, sterol/stanol synthesis markers and a huge diabetes panel.
Offices are able to begin providing this service at no investment. The office must perform the blood draw and package and ship the sample to HDL for testing. (HDL provides the supplies and covers the shipping.) Since Health Diagnostic Laboratories is a full-service lab practices can send any and all lab work to them and receive results through their service, this can cut down on back office confusion of deciding which lab gets which test. When a patient’s results are received by the physician, HDL recommends that the physician see the patient back for a follow-up visit to review the results. HDL’s Advanced Lipid Testing can allow the doctor to bill one to two levels higher than a typical follow-up appointment, which can generate an additional $60-85 for the visit.
In addition, HDL offers the complimentary health coach to its patients to help keep them engaged and on track to their health goals and patient friendly billing.
There are few more good reasons to provide in-office lab work for your patients:
1. It is convenient for the patient. Patients appreciate that they can have everything handled in office at one appointment. It's especially convenient for the simple labs that can be read on the spot.
2. It’s good medicine. Patients are more likely to follow through with needed lab work if they don’t have to schedule a second appointment and take additional time off work to comply.
3. Some services offer accessory benefits to the patient, such as patient-friendly billing and complimentary health coaching.
How do you choose? The important part to remember as you delve into this revenue series is that you must find a revenue stream that resonates with you and your staff, engages your ideal patients, and provides good medicine. When all of those things are in line, you will make the right choice.