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    03 — Value stream · VS-550

    Requisition-to-Payment

    Turn a test order and specimen from an outside clinic or facility into a reported result and payment: take in the requisition, resolve missing patient or coverage information, run and report the test, bill the payer, the patient or the client, and work denials until the account is paid. Tests ordered during a hospital visit are Order-to-Result and Encounter-to-Cash.

    • Lab Outreach Revenue Cycle
    • Specimen-to-Cash
    • Requisition-to-Cash
    • Laboratory Billing Flow
    // FIG. 03 · Stage flow
    1Receive Requisiti…2Verify & Complete3Test & Report4Code & Route Char…5Bill6Collect & Resolve
    1. 01

      Receive Requisition

      VS-550.10

      Check the order against coverage rules and obtain any advance beneficiary notice where the specimen is collected, then accession the specimen and register the patient, the ordering clinician and coverage from the requisition.

    2. 02

      Verify & Complete

      VS-550.20

      Verify coverage and resolve missing or invalid diagnosis, ordering clinician and coverage information with the client before the claim is released.

    3. 03

      Test & Report

      VS-550.30

      Run the test, interpret it where pathology review is needed, and send the result to the ordering client.

    4. 04

      Code & Route Charges

      VS-550.40

      Code the tests and route each charge to the payer, the patient or the client account.

    5. 05

      Bill

      VS-550.50

      Submit claims to payers, invoice clients and send patients their statements.

    6. 06

      Collect & Resolve

      VS-550.60

      Post payments, work denials and appeals, and collect patient and client balances.