If you search for antigen negative units or do consultation for another facility how do you determine what and how to charge for antigen typing? Do you calculate how much a drop of antisera costs and pass that on? Are there any guidelines on how to charge? Thanks

Not only do you have to calculate the cost of the "drop", but don't forget controls, surveys, tech time . . . Also, it depends on how extensive your service is - do you only stock certain reagents or most or all . . . Typing for the more common antigens has to help pay for reagents for those not seen frequently. I see what my blood provider charges and try to be in that ballpark range. I once had a lab manager who asked "Where else can they get it done?" Usually we were the sole provider in the area . . . With the ever increasing costs of reagents/cells, etc I have found that I have to keep my charges fluid and have to make enough profit so that I can keep doing things in house. As you can see, there is not an easy answer to this. Most institutions have a formula for such calculations. I know this doesn't really answer your question, but should provide some food for thought on that subject.

Last month I developed a ref lab agreement with an neighboring facility. When it came time to figure the charges, I realized that we had not cost-per test available for our antigen typing. It was a massive headache, but in the end, I am satisfied that my number is quite accurate. We used that figure to determine how much to charge the other hospital.

I chose to include all our antigens at one set price. However, it is also acceptable to divide your antisera into different "levels" based on cost, etc.

If you are interested, I will be more than happy to share my spreadsheet as well as how I calculated this.

Karen

when a PAT patient needs units for surgery. Do you charge and enter the results under PAT or you wait until the patient is admitted the day of the surgery

Question: We charge for the antigen typing in 3 groups and we only charge for the ones that the patient actually receives the blood for. Does anyone add on a cost that includes the number of units that have to be antigen typed to find antigen negative units? Seems like we waste a lot of money looking for them and that it is often cheaper to just order the antigen negative units from our supplier. Any thoughts on this?

Yes, we charge for all units, positive or negative, we type looking for antigen negative units.  Obviously we don't type 10 units to find 1 K-negative unit, but base the number typed on the compatibility percentage.  We are lucky to have a historical antigen database from our blood supplier, but sometimes we have to "wing" it and just grab a bunch from the shelf and type away!

We do order antigen typed blood from our supplier for some transfusion events. If it's for an outpatient who will be transfused the following day or the day after, we may order units. Its cheaper to do it that way and saves us time on a busy day. If an inpatient needs blood we screen units in our stock and order only if we can't find what we need.

mollyredone stated: Yes, we charge for all units, positive or negative, we type looking for antigen negative units.  Obviously we don't type 10 units to find 1 K-negative unit, but base the number typed on the compatibility percentage.  We are lucky to have a historical antigen database from our blood supplier, but sometimes we have to "wing" it and just grab a bunch from the shelf and type away!

I want to discuss this with the person that does my billing. She led me to believe that unless the patient received the blood, we couldn't charge for any antigen typing on other units. Is there a way to charge for all the units screened that will be accepted by insurance? This would be great for when we order special blood from our supplier and then the MD changes his/her mind. We could charge the patient for the special blood but not the transfusion. (Yes? No?) Obviously I'm new at this charging stuff!

7 minutes ago, lpregeno said:

I want to discuss this with the person that does my billing. She led me to believe that unless the patient received the blood, we couldn't charge for any antigen typing on other units. Is there a way to charge for all the units screened that will be accepted by insurance? This would be great for when we order special blood from our supplier and then the MD changes his/her mind. We could charge the patient for the special blood but not the transfusion. (Yes? No?) Obviously I'm new at this charging stuff!

In the circumstances (I don't live in the USA, so I would never be "In the circumstances"), I would be more keen to charge the MD who has changed his or her mind, rather than the patient!

You took the words right out of my typing fingers Malcolm!

My understanding is that the antigen typing can only be charged for the preparation of a unit or units that are actually transfused. (However, I could be wrong. Billing can be confusing and its a moving target.)

Those dang physicians!  Running up bogus charges!

What we do is similar to Molly, above.  The issue of changing billing regarding whether or not a unit is crossmatched or used does not matter to us. 

If we have an order for a crossmatch for compatible units, we do (and bill for) whatever work is needed to get those ready.  if that involves a simple IS crossmatch, that's what the patient is charged for.  If we have to screen 10 units to find two Ag-compatible, we are going to charge for all of that work. 

Scott