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. Every one of them sits beneath the threshold where anyone would sensibly spend an afternoon — so the rational choice, every time, is 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. Not one catastrophe — ten thousand rounding errors, all pointing 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. Nothing about the test changed — same sample, same analyzer, 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. Note this is cost-to-collect — money spent on staff time, 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 start before the sample ever reaches you — which is exactly why your team can't fix them from where they sit.
The routine panel that becomes a surprise bill
When bloodwork is ordered as part of an annual physical, it's meant to be handled as preventive care — the patient owes nothing. 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 frequently treat it as part of the base test and pay nothing for it — you did the urgent work at standard pay.
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 — no payer, no patient, no exception.
The rate that quietly shrank
You negotiate what each test pays. Payers don't always load the new rates — an outdated schedule stays live and the payment comes in $1 or $2 light. 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 isn't giving up — they're doing the arithmetic, and the arithmetic says move on.
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 shortfalls hide inside adjustments — and you can't manage what nothing shows you.
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. All inside the systems you already use — no system change, 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. They check it against your contract and the claim and decide whether it's genuinely owed — a person making a judgement, not a guess.
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 as preventive, and capture the patient's signature when one is needed — so the rejection never happens and nobody spends $25 fixing a $3 claim.
The 2026 OneMed Laboratory Profit Index.
We aggregated the anonymized results from every laboratory we worked with over the last 18 months — here's what surfaced once someone put a number on the losses nobody tracks.
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. Here's where the money came from — and note what sits 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.