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Effectively managing your reference laboratory relationship.

Clinical Leadership & Management Review : the Journal of CLMA

|December 25, 2003

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Clinical laboratories often outsource specialized testing to reference laboratories due to cost or expertise. Managing physician orders for expensive, esoteric tests, especially with limited reimbursement, presents a significant challenge.

Area of Science:

Clinical Laboratory Science
Healthcare Management
Diagnostic Testing

Background:

Clinical laboratories frequently rely on reference laboratories for specialized testing beyond their in-house capabilities, driven by economic and competency factors.
Selecting a reference laboratory involves evaluating criteria such as reputation, service quality, test menu breadth, turnaround time, cost, and IT support.
Managing physician ordering patterns for high-cost, esoteric tests, particularly those with questionable medical necessity or low reimbursement, is a critical challenge for referring laboratories.

Purpose of the Study:

To address the dilemma of managing physician requests for expensive esoteric tests.
To provide strategies for optimizing the utilization of costly laboratory services.
To explore solutions for referring laboratories facing reimbursement challenges for specialized testing.

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Main Methods:

Review of decision-making factors for selecting reference laboratory providers.
Analysis of challenges in managing physician ordering patterns for esoteric tests.
Discussion of economic and reimbursement issues impacting specialized laboratory service utilization.

Main Results:

Key factors influencing reference laboratory selection include quality, cost, and service support.
Physician ordering of esoteric tests requires careful management due to cost and medical necessity concerns.
Limited reimbursement from payers complicates the use of expensive esoteric tests.

Conclusions:

Effective management of reference laboratory utilization is crucial for clinical laboratories.
Strategies are needed to balance the demand for esoteric testing with economic realities and reimbursement limitations.
Optimizing the use of specialized diagnostic services requires collaboration between referring labs, physicians, and payers.