Small Lab Profit Center? --> RE: Lab Fees - how much?

[Guest guest]

Annie,

Just curious, why not manage the labs as more of a profit center?

Not to gouge the patient, but instead of a wash, why not make a little income from this area.

I know it's not all about the s -- but if this is a service for the patient that you help them with -- why not charge a little more?

I agree we don't want to gouge our patients, but most on the list seem to think we are underpaid, so why not make a little extra here and there?

Just curious.

Cheers

Locke, MD

From: [mailto: ] On Behalf Of Annie SkaggsSent: Monday, November 19, 2007 1:52 AMTo: Subject: RE: Lab Fees - how much?

I use Quest, and they have cut me a similar deal for my self pay patients. I pay Quest (like $3 for a fasting lipid panel) and the patient pays me (I add $4 so the patient pays $7 for the FLP that Quest would charge $76 for)

Great deal for my self pay patients.. a wash for me

From: [mailto: ] On Behalf Of vargasca1@...Sent: Sunday, November 18, 2007 8:34 PMTo: Subject: Re: Lab Fees - how much?

Charlie Vargas chiming in from lin, NC.I dont do labs in my office; instead I send folks to either the local health department or hospital. Neither is clearly cheaper on all the labs, so I try to pick and choose based on which labs I am ordering.For the uninsured, though, who pay out of pocket, I recently found out that it would be much, much cheaper for them if I bill for the labs up front at my office, then send them to the hospital for the labs to be drawn. The hospital then turns around and charges me. I pay the hospital. The labs are cheaper, on the order of 200 to 300 percent, because the hospital doesnt have the overhead of paying people to file and refile and fight and argue and waste time chasing their money from insurance companies who wont follow through with their end of the bargain and...I digress.Anyway, what I might do is charge the cost of the labs, 25 dollars for a 25-hydroxy vitamin D level, for example, and a fee for my time, say around 25 dollars. Or not.This might be an interesting option for those of you who struggle when ordering labs for the indigent.A wonder how Bob Forester of St. Lukes Family Practice does it. Whats your take on this, Bob?CharlieDate: 2007/11/17 Sat PM 12:36:28 CSTTo: Locke's in Colorado Subject: Lab Fees - how much?Our office has an agreement with the local hospital to perform our labs. We order the labs, we bill for the labs, we get or lose the money if the patient doesn't pay. The hospital then bills us for the service -- each lab is charged to us. I'm having a difficult time figuring out what to charge for these services.Below are some thoughts -- I've avoided giving my actual charges and I'm not asking for your exact fee schedule.Just want some ideas on how to set a reasonable fee for labs. Any thoughts on the below? Locke, MD====================================================I am using the old charge schedule from my old group, but some of these charges seem above and beyond the normal markup for service. For example... Test X -- our clinic charges $94 -- the hospital bills us $9 -- so this is over a 1,000% markup!I'm not sure what we are getting reimbursed from insurances since I don't have access to my old practice's practice mgt system and haven't started getting EOB's back from insurances in my new system. The Ingenix RVU book says the RVU for this CPT code/lab Test X is 2.9.Our best conversion factor is 10.38Am I correct in assessing that based on RVU's, the Text X is worth $30.10? Interestingly, others in the valley and the hospital charge even more than we do...to my understanding. I haven't been able to go back and double check the old EOB's at my old clinic, but I get the impression this is not outside the norm for markups. I tried to find some free standing fees on the web...ie free standing lab with a fee schedule, but couldn't find much. Our hospital charges us back $10.30 for a PSA -- the health clinic below charges $20 -- so well within the range of not losing money on the test they do.We charge way above that amount.This site has a value for Medicare, but not sure what it means -- it is 84153 $25.70http://www.umd.nycpic.com/2007_clinical_lab_fee.htmlHouse call doctor charges...http://www.maisenmedicalpractice.com/services.htmlPSA (Prostrate Specific Antigen)........................................................ $30 TSH (Thyroid Blood Levels)...............................................................$25 This naturopath charges...http://www.drjimchan.com/fee_schedule.htmTotal PSA (Prostate Specific Antigen) $38.50 TSH (Thyroid) $38.50 =================================There was a health clinic with fees at... http://www.lchd.us/fee_schedule.htm#MISC.%20CLINICS%20 & %20SERVICES WELLNESS CLINIC $ 30.00 WELLNESS SCREENING TEST $ 35.00 WELLNESS SCREENING TEST - AT WORK SITE $15.00 Wellness recheck lipid panel $15.00 Wellness recheck liver function $ 20.00 PSA LAB TEST $15.00 TSH lab test $25 .00 Diabetes Hgb A.C. $ 6.00 OSTEOPOROSIS HEEL SCREEN IF INCLUDED WITH WELLNESS MISC. CLINICS & SERVICES $ 10.00 OVER CURRENT LAB FEE HEP B SURFACE ANTIBODY TEST $ 10.00 HEMOGLOBIN $ 8.00 HEARING TESTING $ 8.00 VISION TESTING $ 30.00 BLOOD LEAD TESTING $ 5.00 BLOOD DRAW LEAD $ 10.00 PREGNANCY TESTING $ 40.00 SCHOOL SPORTS PHYSICAL $ 25.00 SMOKING CESSATION CLASS $ 12.00 OSTEOPOROSIS HEEL SCREEN $15.00 per person CPR CERTIFICATION (Minimum of 5 per class)T.B. CLINIC FEES $7.00 MANTOUX SKIN TEST $14.00 2-STEP MANTOUX TEST $10.00 + COST APLISOL OR TUBERSOL VIAL