Interpretation of Labs

[NeoTrion]

This question came up during a conversation at lunch today.  We have a physician that loves to send us labs that he ordered.  We were just curious that in a clinic setting, is interpretation of these labs billed under whomever ordered the lab?  The physician often orders labs and pushes them toward the NPs and PAs without telling us what he is looking for.  I have occasionally have had my SP come behind me and order Rheumatology labs without telling me what he is looking for.  The way I was trained is that if you order the lab, then you own the lab.  For a while I would send them back saying I didn't order this, and got called out in a staff meeting.  I stood my ground saying "If you would communicate to me exactly what you are looking for, I would be able to provide better care."  Of course this didn't sit right with the SP.  It was agreed at the meeting that communication needs to be improved for this to happen.  Unfortunately this didn't happen and my SP continues to do this.  My question is interpretation of labs a separate charge,   or is it built into the cost.  We are a clinic with our own lab.  I just want to know what the thoughts of the brain trust are!

[beattie228]

To my knowledge, you cannot bill separately for interpretation of the results. This is built in to the initial charge when the order was written.

 

Goes without saying, but it's a big liability on your end to be interpreting labs without clinical correlation or understanding of the medical decision making of the person who ordered it. Your SP is trying to eat his cake and have it too. I'm happy to review a CBC or CMP, but the odd-ball labs ordered by my colleagues that I don't have a clear understanding of the who, what, when and why get turfed back to the ordering provider.

[GetMeOuttaThisMess]

To tick off some of my patient population even further ("He asks too many questions"), I'll sometimes ask female dysuria patients if they were the provider and had the option of talking to and examining the patient only, versus looking at a UA only w/o patient interaction, which of the two is more reliable?  Everyone says the UA because test results are written in stone.  The answer is the opposite, about 85 to 65%.  Reasoning is you can explain away abnormal UA findings to other possible processes.

[ventana]

the doc is pushing the non-reimbursable work to you

 

you are not a scut worker

 

carefully bring it up again, if that does not work try the passive aggressive approach of asking him on everyone, in email, that he has to reply to before you can answer patient.  He will eventually get tired of this and do it himself (which is what it should be)

[Guest JMPA]

Who profits off the labs being ordered? Who gets in trouble for fraud when labs are sent for profit? sometimes the answer you are looking for does not involve medicine.

[NeoTrion]

I have since left this position due to other issues as well.  He saw things as a team approach and could not understand why I had an issue with this.  Of course this is the same SP that dumped his schedule on another PA and myself, because his wife decided he had to go get a haircut......  Again he stated we are all a team, but if we were sick he would not take our patient's.  After both of us left he stated he would no longer higher any more PAs or male providers. Awesome stuff there.