🇺🇸United States

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

2 verified sources

Definition

If the ordering organization cannot see where a send‑out specimen is in the process and when the reference lab has resulted it, claim submission waits until manual result entry or phone/fax confirmation. Industry guidance on lab test tracking notes that automated logging of handling steps and integration with LIS/EMR is key to keeping tests moving and avoiding delays.[3][7][10]

Key Findings

  • Financial Impact: 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
  • Frequency: Daily
  • Root Cause: Disjointed workflows between ordering provider, internal lab, and external reference lab; reliance on manual result entry from fax or portal; absence of status feeds that trigger billing once testing is complete; and no central dashboard showing send‑out aging.[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 outreach managers, Accounts receivable specialists, Practice administrators

Deep Analysis (Premium)

Financial Impact

$10K annual carrying cost per $1M revenue • $10K-$20K annual carrying cost per $1M send-out revenue from 5-10 extra DSO days • $10K-$20K annual carrying cost per $1M send-out revenue from extended AR

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Current Workarounds

Client services maintains ad‑hoc lists of pending send‑outs, repeatedly logs into multiple reference lab portals, calls for status updates, chases missing faxes, and then triggers internal staff to manually key or scan results into LIS/EMR so claims can finally be generated. • Client services manually chases status by calling the reference lab, checking their web portal, digging through fax inboxes, and then asking in‑house staff to key results into LIS/EMR so the claim can finally be submitted. • Courier/logistics coordinator and hospital lab staff track send-outs and results using ad-hoc logs and back-and-forth communication instead of integrated LIS/EMR status feeds.

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Methodology & Sources

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

Evidence Sources:

Related Business Risks

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

$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)

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

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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