🇺🇸United States

Lost charge capture for send‑out tests due to poor tracking and order/result mismatches

2 verified sources

Definition

When reference lab send‑outs are tracked manually or outside the LIS, tests performed by the external lab are not always matched back to the originating order, so the hospital/clinic never bills the payer or patient. Industry studies on lab revenue cycle show that missing or incorrect test information and poor interface between ordering and billing systems are a recurring source of lost charges in outsourced testing.

Key Findings

  • Financial Impact: $50,000–$250,000 per year for a mid‑size health system heavily using send‑outs (extrapolated from studies showing 3–5% of lab tests at risk of underbilling or non‑billing when tracking is manual or fragmented in outreach and reference lab programs)
  • Frequency: Daily
  • Root Cause: Fragmented workflows between EMR, LIS and reference lab portals; manual spreadsheets or paper logs for send‑out tracking; lack of automated reconciliation between reference lab test performed reports and internal charge capture; and absence of end‑to‑end specimen tracking tied to billing events.[3][7][10]

Why This Matters

This pain point represents a significant opportunity for B2B solutions targeting Medical and Diagnostic Laboratories.

Affected Stakeholders

Revenue cycle managers, Laboratory directors, Outreach/reference lab coordinators, Billing specialists, Pathology practice administrators

Deep Analysis (Premium)

Financial Impact

$10,000–$40,000 per year in unbilled or disputed send-out charges because there is insufficient tracking to demonstrate which specimens were successfully processed and should be invoiced to sponsors under study contracts. • $10,000–$50,000 per year in lost or late charge capture for outsourced protocol-specific tests where results were received or performed but never tied back to a billable research order or contract line item. • $10,000–$75,000 per year in lost revenue where shipped send‑outs never make it into the billing record or are duplicated, along with soft costs from delayed results and staff time spent tracking down missing tests.

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Current Workarounds

Billing staff manually reconcile reference lab invoices, paper/faxed/portal results, and LIS orders to identify unbilled tests, then hand‑key or request late charges and adjustments. • Client services reps look up information across multiple systems (LIS, reference lab portals, carrier tracking, billing) and maintain their own status notes or trackers for problem send‑outs. • Custom Excel dashboards or manual logs.

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Methodology & Sources

Data collected via OSINT from regulatory filings, industry audits, and verified case studies.

Evidence Sources:

Related Business Risks

Excess courier, shipping, and labor costs from inefficient send‑out specimen tracking

$5–$15 per package in avoidable premium shipping and re‑shipment costs; $100,000+ per year in combined excess shipping, courier hours, and staff search time for a reference‑heavy hospital lab (based on vendor ROI cases where automated tracking reduces labor and courier expenses by double‑digit percentages)

Lost, misrouted, or compromised send‑out specimens leading to redraws and repeat testing

$50–$200 per affected case (recollection visit, staff time, shipping and test repeat) and easily $100,000+ per year for large labs given frequent redraws and repeats on send‑outs reported in quality programs

Delayed billing and extended AR from slow send‑out status visibility

5–10 days of added days sales outstanding (DSO) for send‑out claims is common in labs without integrated tracking, equating to tens of thousands of dollars in carrying cost for every $1M of annual send‑out revenue

Technologist and coordinator time wasted searching for and reconciling send‑out specimens

0.25–0.5 FTE per shift in many busy labs (tens of thousands of dollars annually) devoted to chasing send‑outs and reconciling logs vs. automated tracking; large reference labs report needing dedicated staff just to trace missing shipments before implementing advanced tracking

Chain-of-custody and traceability deficiencies risking CLIA/ISO nonconformities for send‑outs

$10,000–$50,000+ per major survey finding when considering internal remediation, consultant costs, and potential lost business if accreditation is at risk; repeated deficiencies can also threaten contracts with payers and referring providers.

Opportunity for inappropriate test billing and misuse of send‑out workflows due to weak tracking controls

$10,000–$100,000+ per year in potential over‑testing and non‑covered tests that may later be denied or clawed back, depending on send‑out volume and payer mix

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