[MT-L] reflex orders from a reference lab

[Precourt, Michelle]

How does you lab handle reflex testing from reference labs? Do they call and you place the order? Is there someway that the reference lab can place the order?

Michelle Precourt
LIS Manager
215-590-5466

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[Paul Goedicke]

My current experience with LabCorp and previous experience with Quest is that if they have a test defined with a reflex, they do it automatically. If you have a reflex defined just within your Lab, you'll either need to match it to something the reference lab has, have the reference lab create a custom panel with the reflex, or split samples and submit a new order and sample based on initial results.

Paul Goedicke
Clinical Analyst III
Jackson County Memorial Hospital
1200 E. Pecan Street
Altus, OK 73521
Phone (580) 379-5565
Fax (580) 379-5559
paulgo...@jcmh.com
When you're chewing on life's gristle
Don't grumble, give a whistle
And this'll help things turn out for the best...
And...always look on the bright side of life...
Always look on the light side of life...
Monty Python's Life of Brian 

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[Jim Sehloff]

A bunch of years ago at a MUSE meeting I did a presentation on how I set
this up to work so that tests reflexed and charged correctly. I have
most of my MUSE presentations at home right now so I cannot find it
immediately. Basically there are a couple ways to handle this. I use
order groups mostly to add as needed based on the results that Quest
sends. For some tests I have a huge panel with the reflex tests
automatically resulting to NP. I have an order group set up to reflex a
charge test if a result is entered. Let me know if you think the
presentation would be useful and I will send it.

Jim Sehloff
M.S. MT(ASCP)
Information Security Analyst
CareTech Solutions
Holy Family Memorial, Inc.
P.O. Box 1450
Manitowoc, WI 54221-1450
(920) 320-2799
(920) 973-4431 (cell)

-----Original Message-----
From: meditech-...@mtusers.com
[mailto:meditech-...@mtusers.com] On Behalf Of Precourt, Michelle
Sent: Wednesday, September 08, 2010 7:25 AM
To: medit...@mtusers.com
Subject: [MT-L] reflex orders from a reference lab

[Gary Hall]

LAB KB article 30312 is what Meditech pointed me to. We actually do it a little differently, here's the verbiage from the task, if this helps:

GARY: "I tried a different option, based on one of the ways we were doing this when we went live on Mayo's new MayoAccess in January. Instead of using the calculation and the charge test, I just put the auto-result of ND in page 2 of the reflex test. As far as I can tell, that worked. When I left ND in the auto-result while resulting the test & reflex, it showed as Test Not Performed on the result report, and it showed as a compensating credit to the debit on the Billing Inquiry in LAB. When I overwrote the ND with a result while resulting a test & reflex, it showed on the result report and the charge showed on the Billing Inquiry. (Note that I also had to put the charge back in page 1 of the reflex test.) Is there any reason why this approach wouldn't work, also? It's a little simpler, but I don't want to go this route if it's going to have some flaw...thanks!

MEDITECH: "That is certainly an option. The reason why some prefer to handle this differently is because they would not want the test to print on the report if was not reflexed by the reference lab. With resulting the possible "reflex" test with ND, as you saw the test will still print on the report. If this is not an issue with your facility then you can certainly use that set up instead of using the calculation and charge test."

Gary Hall
Director of Information Technology
Estes Park Medical Center
970-577-4443 (office)
970-744-9052 (cell)
970-577-4355 (fax)

[Mike Thayer]

We do the same thing that Jim is doing.... anything that CAN have a reflex test is built as a panel with all the possible tests set to default to NP unless performed. We have some charge rules to get the billing correct for panel pricing on tests that can be ordered individually that are part of the reflex.

Mike Thayer, CLS
Laboratory Information System Coordinator
Clinical Laboratory
Shasta Regional Medical Center
1100 Butte Street
Redding, CA 96003
530-229-2858
mth...@primehealthcare.com

-----Original Message-----
From: meditech-...@mtusers.com [mailto:meditech-...@mtusers.com] On Behalf Of Jim Sehloff
Sent: Wednesday, September 08, 2010 6:30 AM
To: Precourt, Michelle; medit...@mtusers.com

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[Peyjam, Fariborz]

The way I do is I include all of the reflex resultable tests into my order panel so If they send the result with reflex then I have a result code to match them up with. I have auto result them with NP just in case there is no need to reflex.

Fariborz Peyjam
Project Manager - Clinical Applications
Mount Sinai Health Systems
Chicago, Illinois
Phone: (773) 257-5257
Fax:     (773) 257-2268
email: faribor...@sinai.org

 

-----Original Message-----
From: meditech-...@mtusers.com [mailto:meditech-...@mtusers.com] On Behalf Of Jim Sehloff
Sent: Wednesday, September 08, 2010 8:30 AM
To: Precourt, Michelle; medit...@mtusers.com

[Birkenholz, Karen]

How does the billing work when you do it this way? Do you manually credit the charges for the reflexed test if it is NOT reflexed?

Thank you,
Karen Birkenholz, MT (ASCP)
LIS Analyst
Norman Regional Health System
phone: 405.307.1135
pager: 405.327.0774

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[Paul Goedicke]

As Jim indicated, an Order Group to charge the reflex test based on results is the cleanest way to charge for the reflex - that way you don't get in trouble with Medicare in case one doesn't get credited (if you charge for the reflex up front). Other sites use a manual process, which could miss getting some charges entered.

Paul Goedicke
Clinical Analyst III
Jackson County Memorial Hospital
1200 E. Pecan Street
Altus, OK 73521
Phone (580) 379-5565
Fax (580) 379-5559
paulgo...@jcmh.com
When you're chewing on life's gristle
Don't grumble, give a whistle
And this'll help things turn out for the best...
And...always look on the bright side of life...
Always look on the light side of life...
Monty Python's Life of Brian 

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