Ask The Expert

My lab is constantly hot. I worry it may affect the lab instruments. What should I do?

The summer is especially hard on most offices to maintain a comfortable temperature. The lab must maintain a temperature that is consistent with the manufacturer’s recommendations. For instance, if you have a lab instrument that the user’s manual states must be operated between 60 – 80 F, then you are required to monitor your lab to assure the temperature stays within this range.

The manufacturer sets the requirements for monitoring. If they state ranges for temperature and/or humidity, then these must be monitored and documented.

I just went to factory training for an instrument we will use in the lab. Can I train other lab people to use this instrument?

Yes, you can. You are allowed to train them for the use of the instrument if you have been certified by the manufacturer as competent and trained. However, if you leave the practice, the person you have trained cannot train others. They would have to attend factory training to be able to train others. Training basically only goes on layer deep and all training has to be documented in the employee’s file.

I was recently notified of an upcoming inspection for our office. I just realized that the Medical Director will be out of the office that day. Should I try to reschedule?

The Medical Director is not required to be there for an inspection but it is a good idea. If the Director cannot be present, you can try to reschedule the inspection. Inspection notifications are, by nature, unannounced. You are usually given only a few days notice so it may not be possible to reschedule.

We are not on an EMR (electronic medical record) system yet. How can I be sure all my charges are being captured for the testing that is perform in my office lab?

In short, you can’t. You can put certain measures in place to make it easier to record this information, but the human factor is hard to overcome.

Two things have to take place for you to get paid for your lab testing.

1.) The lab has to record all tests that are performed (a daily log, etc)

2.) The tests performed have to be coded and billed.

Some offices I know that are still on paper records, have the lab take the list of tests performed that day to the billing office to be reconciled with what was charged that day. This will show if a problem is brewing from either charges not being marked on the billing ticket or tests not being recorded on the daily log. One physician I know claimed he was losing money on CBCs he performed in house. I asked how many he was running a day. He said that his office performed at least twenty CBCs per day. When I checked with the billing office, they only showed recorded charges for about 4-5 per day.

The billing ticket was not being marked for the tests performed about 80% of the time. This also applied to other tests that were being performed. Once we resolved this issue, his revenue went up by almost 80% simply because he started getting paid for the tests he was already performing.

The insurance companies do not really care if you don’t get paid for tests you perform. They look at it as your responsibility to bill for the tests done. They do however have a large problem with paying for tests that were not performed. This is call “insurance fraud” and can lead to “jail time”.

Example: Mr. Smith is told to collect a urine specimen as part of his checkup. He has his blood work drawn and is given a cup to collect his urine specimen. The billing ticket is marked for his blood work and urinalysis. Mr. Smith cannot collect a urine and promises to try again before leaving. He still is not able to collect urine at the end of his visit, and leaves, checking out at the front desk.

His billing ticket still reflects the urinalysis, and his insurance is charged.

To avoid this situation:

1.) Do not mark the charge ticket until the testing is confirmed

2.) Have the checkout person verify with the patient what tests were ordered and collected

Not capturing charges is one thing, but billing for tests not performed is a different animal.

BE CAREFUL OUT THERE!