What is Carent Laboratory Solutions?
We’re an alliance of multiple hospital-based laboratories in the Rocky Mountain region, with principal locations in Colorado.
Why was Carent Laboratory Solutions formed?
In the past contracts between large for-profit commercial laboratories and insurance companies have prevented hospital-based labs from providing services to patients whose laboratory test orders originated in physicians’ offices (considered Outreach
” work). Unlike other hospital services (i.e. radiology), hospital labs have outpatient competition from national laboratories. Without an option like Carent, insurance companies have been able to isolate lab services and negotiate exclusive contracts with these national reference laboratories for the right to perform non-patient lab testing. In doing so the insurance companies have benefited by receiving lower prices for tests, simplified negotiations, and reduced paperwork in processing small dollar claims from a large number of independent facilities. However, patients are compromised in that they are denied access to local, integrated healthcare.
What is the purpose of Carent Laboratory Solutions?
We aim to secure ancillary contracts from which hospital labs were excluded in the past due to geographically-limited coverage areas and the development of national reference laboratories. We have brought together hospitals to offer single-source contracting, billing, quality and utilization data, and provide a viable alternative to the national testing laboratories for insurance companies. Ultimately, the purpose of Carent is to become the “farmer’s market” of laboratory testing, keeping the business local.
How does my local hospital benefit from membership in Carent Laboratory Solutions?
As stated above Carent members have access to “non-patient” or ancillary contracts that they did not have before.
How is my billing done?
- Access to these contracts benefits local hospitals and communities by helping them strengthen outreach programs and increase test volumes. This helps utilize excess capacity which in turn decreases total cost of inpatient testing and increases revenue, allowing them to reinvest in local healthcare.
- Carent member hospitals are able to offer integrated clinical lab services across inpatient, outpatient, and physician office care settings. Contracted health plan outreach testing remains within the health system giving physicians access to the complete clinical data set. This allows them to maximize utility in the continuum of patient care and to see the entire history of the patient more easily.
- Member hospitals have continued to serve their traditional client base, allowing them to improve patient continuity of care by performing the bulk of their testing locally. This reduces episode of care costs and duplicate testing through faster turn-around times and access to local pathologist consultation and extended consultation with contracted reference laboratories.
Billing and collections for most outreach programs are handled by the hospital billing system for inpatients which makes it difficult to measure net revenue. Since the network utilizes one tax ID number the network outsources all Carent lab bills to a third-party billing company.
Where are my tests done?
As part of our mission to keep laboratory testing local approximately 98 percent of all tests are performed by the local community laboratory members. In the event testing capabilities don’t allow the test to be performed by an individual member, they have the option of transporting it to another network member, such as another laboratory in the network or to contracted reference laboratories.