Laboratory Financial Management & Reimbursement Flashcards
7 cards from real CLC practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Laboratory Financial Management & Reimbursement flashcards as text
In laboratory financial management, 'cost per reportable' is calculated as:
Answer: Total costs divided by the number of valid, reportable test results produced
Cost per reportable divides all costs by only the valid reportable results, capturing inefficiencies from failed runs, repeats, and QC failures that cost per test ordered would miss.
In laboratory economics, 'contribution margin' for a test is defined as:
Answer: Revenue minus variable costs, showing the amount available to cover fixed costs
Contribution margin equals revenue minus variable costs, indicating how much each unit of service contributes toward covering fixed costs and ultimately generating profit.
Which productivity metric is most commonly used to benchmark laboratory workforce efficiency?
Answer: Tests per full-time equivalent (FTE) employee
Tests per FTE is the primary laboratory productivity benchmark, measuring how many tests each full-time equivalent staff member produces and enabling staffing comparisons against industry peers.
When performing a break-even analysis for a new laboratory test, the consultant is determining:
Answer: The test volume at which total revenue equals total costs
Break-even analysis identifies the volume where revenue exactly covers all costs; volumes above break-even generate profit, while volumes below result in losses.
Analyzing 'send-out' (reference laboratory) test costs is most useful for a laboratory consultant to:
Answer: Identify high-volume or high-cost tests that may be economically justified to bring in-house
Send-out analysis by test, volume, and aggregate spend reveals candidates for in-sourcing where volume would support capital investment and reduce turnaround time while improving margins.
A laboratory's Charge Description Master (CDM) should be reviewed periodically to ensure:
Answer: All services are correctly coded, appropriately priced, and compliant with billing regulations
The CDM is the master list of all laboratory services with associated CPT codes and prices; regular review prevents coding errors, outdated prices, and compliance vulnerabilities.
When evaluating the true profitability of a laboratory outreach program, the most meaningful metric is:
Answer: Net revenue per test after deducting collection, transport, and processing costs
Net revenue per test after all outreach-specific costs (phlebotomy, transport, supplies, billing overhead) accurately reflects true profitability, unlike gross revenue which overstates the program's financial performance.