Tests in Tasy: from order to result with nothing left pending
A test ordered and forgotten delays discharge; a test done and not posted is lost revenue; one posted and not done is a certain denial. The path from order to result in Tasy and what to measure.
Lab and imaging tests cross the whole hospital: ordered in the clinic, the ED and the wards, performed in another department, sometimes by a third party, and returned as a report to whoever ordered them. In Tasy, each step has a status. The typical problem is not a test that goes wrong; it is a test stuck at a step without anyone noticing: the inpatient waits an extra day for the CT, and discharge slips.
The path of an order
| Step | What is recorded | Who |
|---|---|---|
| Order | Test, indication, urgency, on the right encounter | Physician |
| Authorization | Payer authorization, when required | Payer relations |
| Booking or collection | Time slot (imaging) or labeled collection (lab) | Scheduling, nursing, phlebotomy |
| Execution | Test performed, equipment, technician | Lab or imaging |
| Report | Result released by the person in charge | Lab, radiologist |
| Delivery | Result available in the record or given to the patient | System, front desk |
Statuses vary with the setup (ordered, booked, collected, in analysis, released, cancelled). What matters is that every order ends as released or cancelled with a reason.
Inpatients
For admitted patients, test time is bed time. Three points of care:
- order on the inpatient encounter, not on an external one;
- a daily list of pending tests by unit, with time since the order;
- critical results communicated through the hospital's workflow, as well as recorded in the system.
A test that only happens the next day for lack of a slot is a frequent cause of an extra inpatient day (average length of stay).
Emergency department
In the ED, time to result sets time to decision. Measuring from order to release, by test type, shows whether the bottleneck is collection, sample transport, equipment or reporting.
Outpatients
Tests for outside patients (ordered by another physician) arrive through scheduling and the front desk. The points of care are those of the front desk in Tasy: payer, authorization and physician's order checked before the test.
Tests and the account
- Test done and not posted: lost revenue. It happens with bedside tests, portable equipment, or units not integrated with Tasy.
- Test posted and not done: cancelled at execution and not on the account. In audit, it becomes a denial and friction with the payer.
- Test without a physician's order in the record: clinical denial.
- Test without authorization, when required: administrative denial.
A periodic reconciliation between tests performed (in the lab or imaging system) and tests posted on accounts catches the first two. See how the encounter becomes an account.
Outsourced lab and imaging
When the lab or imaging service is outsourced, results and billing go through an integration or manual posting. The points of attention are the monthly reconciliation between what the third party billed the hospital and what the hospital billed the payer, and the report turnaround agreed in the contract.
KPIs
- Time from order to result, by test type and source (ED, inpatient, outpatient).
- Tests pending more than 24 hours for inpatients.
- Cancelled tests by reason.
- Tests performed and not posted to the account.
- Tests per patient-day and per visit, by specialty.
- Diagnostics denials, by reason.
Who writes this
Domínio has worked for more than 20 years with hospitals that run Tasy and follows the reconciliation between what was performed and what was billed. To measure the tests your hospital does and does not bill, talk to us on WhatsApp or at comercial@dominiocontabil.com.br.
Related questions
Who follows an inpatient's pending tests?
The unit's nursing team, with the daily list, and the attending physician at rounds. Lab and imaging follow their own queues.
Does a cancelled test need a reason?
Yes. Without it, nobody knows whether it was a duplicate order, the patient was discharged or preparation was missing.
How do I get turnaround time from Tasy?
From the difference between the order and the report release. Both timestamps must be recorded when they happen.
What about critical results?
Follow the hospital's protocol: direct communication to the physician in charge, recording who received it and when.
Written by the Domínio team behind Clic Health: accountants, controllers and developers with more than 20 years of work with hospitals that run Tasy. Have a question about Tasy? Talk to us on WhatsApp.