Home Specialities Laboratory
Pennies per test
volume is the whole game
Rates checked to contract
every test, every payer
Small shortfalls, worked in bulk
the ones you can't chase
Revenue recovery
on tests already run
Your losses are too small to fight and too many to ignore.
This is the trap that defines lab billing. A shortfall is 50 cents. A rush fee is $15. A rejected claim is worth less than the time it takes to fix. Each loss is usually too small to justify spending an afternoon on it, so the rational decision is often to let it go.
Across the 24 laboratory revenue cycles we've analyzed, an average of 5–8% of revenue quietly disappears this way. On a $5M lab, that's $250K–$400K a year. This is not one major failure. It is thousands of small underpayments, write-offs, and rework costs all moving in the same direction.
See what it's costing youWhat 5–8% looks like on a $5M lab
The 5–8% range reflects OneMed's analysis of 24 laboratory revenue cycles; the dollar figures apply that range to a $5M example lab. Your actual exposure depends on test mix, payer mix, and rejection rate.
A clean claim costs $3. A rejected one
costs $25.
This is the most expensive sentence in laboratory billing. The test did not change. It was the same sample, the same analyzer, and the same result. The only difference is a typo, a missing ID, an eligibility slip. And it costs you eight times more to get paid for exactly the same work.
Same test. Same result. Two very different costs.
Illustrative per-claim processing costs, commonly used as industry rules of thumb. This refers to cost to collect, which means staff time spent resolving issues, not revenue withheld by a payer. Your real figures depend on staffing, systems, and rejection rate.
Five ways a test gets run for nothing.
Most of these problems start before the sample reaches the lab, which is why your team cannot fully fix them from the billing queue.
The routine panel that becomes a surprise bill
When bloodwork is ordered as part of an annual physical, it is usually meant to be handled as preventive care, with no patient responsibility. Billed the ordinary way instead, it lands against an unmet deductible. The patient opens a $150 bill they were told they'd never get, and refuses to pay it. You've now run the panel for free and damaged the relationship.
The rush that nobody pays for
When a physician needs results now, you break the batch, pull staff onto it, and expedite the run. That costs real money, which is why there's a surcharge. Payers may treat urgent handling as part of the base test and pay nothing extra, even though the work required faster processing and additional effort.
The signature that never got taken
Some tests require telling the patient in advance that coverage isn't guaranteed, and getting their written agreement to pay if it's denied. Without that signature, the denial arrives and you're not permitted to bill the patient either. The test becomes unrecoverable. There is no payer payment, no patient payment, and no exception to pursue.
The rate that quietly shrank
You negotiate what each test pays. Payers do not always load new contracted rates correctly. An outdated fee schedule may stay active, causing payment to come in $1 or $2 below contract. On one chemistry panel that's invisible. Across 50,000 of them it's a pay cut nobody agreed to.
The claim you pay for twice
A clean claim costs about $3 in staff time. A rejected one — a typo, a missing ID, an eligibility slip — costs $25 or more to investigate, fix, and resubmit. Run a 15% rejection rate and your most experienced billers spend most of the week redoing clerical work instead of collecting aged money.
Bandwidth, not effort
Your team isn't losing this money through carelessness. They're losing it because the math and the paperwork are both stacked against them.
The math beats them
When fixing a shortfall costs more than the shortfall, no amount of effort helps. Your team is not giving up. They are doing the math, and the math says a small claim is not worth manual follow-up.
They're drowning in volume
Thousands of claims a month. Nobody can hand-check every payment against a contract or spot a $1.50 lag. They triage, and the small-dollar errors are always what falls.
You can't see it from the deposit
As the director you get one number a month. Rework hides inside payroll, and short payments hide inside adjustments. If those losses are not visible, they cannot be managed.
Fix it upstream, then work the rest at scale.
Two things your own team structurally can't do: reach into the ordering office to fix the paperwork before the sample arrives, and work thousands of small denials economically. That's the job. We work inside the systems you already use, with no system change and no disruption.
See what it's really costing
Our ClearView dashboard puts numbers on what nobody measures: what you wrote off, what rework is costing you in staff time, which payers are paying below contract, and where the rejections come from. For most labs it's the first time those figures have been visible at all.
Experienced people review it
When a payment looks short, it goes to reviewers who know laboratory billing. Specialty reviewers compare the payment against your contract and the claim, then decide whether the amount is actually owed. That requires human judgment, not guesswork.
Work them in bulk, and appeal
The shortfalls that aren't worth a phone call individually are absolutely worth recovering together. We work them at scale and appeal what was underpaid, so the arithmetic finally favours you.
Stop them at the front end
We help your team verify coverage before the draw, bill preventive work correctly, and capture the patient’s signature when required. That prevents the rejection before anyone spends USD 25 trying to fix a USD 3 claim.
The 2026 OneMed Laboratory Profit Index.
We reviewed anonymized results from every laboratory we worked with over the last 18 months. The patterns became clear once the untracked losses were measured.
24
laboratories analyzed
4.2M+
claims reviewed
$210K
average recovered per lab
↓45%
average claim rejections
Days in A/R fell by 18 on average. This is where the money came from, and the largest category was at the top. the largest single item isn't a payer withholding anything. It's what you spend re-doing your own claims.
| Where the money came from | Share of the total |
|---|---|
| Rework reduced (staff time, not payer money) | 42% |
| Contracted rates corrected | 21% |
| Preventive billing & patient-signature fixes | 18% |
| Rush fees recovered | 12% |
| Other underpayments recovered | 7% |
Aggregated across OneMed laboratory engagements over the trailing 18 months. Individual results vary by lab, test mix, payer mix, and starting point. The rework line represents operating cost avoided rather than revenue collected from a payer.