1. The practical guide to the U.S. Physician office laboratory (POL) Part five: Economic considerations Laboratory Informatics Institute May 2014

2. Profitability and sustainability of the POL Insurance reimbursements Billing Return on investment (ROI) 3. Profitability and sustainability for the POL Achieving profitability is important for a POL. Maintaining sustainability over time is also important. Return on investment is one factor to look at when looking at this category. 4. Insurance reimbursements Vary by company and plan. Without the Doc Fix: providers would have experienced a 30% rate reduction in reimbursements. Laboratory billing personnel should check with companies and plans for current rates. 5. Laboratory billing Medical coding Procedure codes Logical Observation Identifiers and Names and Codes (LOINC) may be used, but it is more common to map to another code set. Lab specific information (CLIA certification etc), patient medical record number, demographics, ordering physician, and test complexity information may present on a bill. 6. Medicare laboratory billing went through a process of standardization for 23 tests in 2003. Those 23 tests cover 2/3 of all testing. 7. Return on investment (ROI) Return on resources invested in project. Not always positive Simple ROI Discounted ROI To see an example of how to calculate ROI and learn move, visit the white paper link at the end of this presentation. 8. For more information Link to white paper with references: http://tinyurl.com/oqorxvu Contact the institute via our website: http://tinyurl.com/o5o23fp