How To Negotiate Discounted Lab Pricing For Your Patients

Set up client bill accounts with the lab of your choice. This takes some time, especially the part where you integrate ordering into your EMR, so start early.

First, what is client bill? A physician can make an arrangement with a lab where that physician gets deep discounts on labs for their patients. Like labs on the order of $2-3 whereas with insurance or if the patient was to pay cash, they might charge 10-100x that for the same exact test done in the same exact location.

The lab has a secure payer source and a referral stream from that physician. Thus they do not have issues with non-payment while they also get that physicians referral loyalty. 

The labs give physicians deep discounts on labs which we can pass on to our patients. We bill our patients directly and the lab bills us monthly for labs that were done by our patients.

Pick a lab that is available in your area. Labcorp and Quest are the biggest ones, but make sure to check that there is a location near where your patients will be.

It gets a bit tricky when your patients want to use their insurance instead of your lab rates. They may choose this if

1. They have a $0 copay for all labs

2. They don’t understand that their insurance will probably charge more. 

It is important to review your bill every month to ensure you did not get charged for labs where you waived patient fees because they said they would use insurance. If you do get billed, you can call the lab and tell them to bill the patient\’s insurance retroactively.

This is kind of a pain – I have considered adding a nominal fee for patients who ask to use their insurance for labs.