How to collect lab fees before the first consult

Yes, a cash-pay practice can collect lab fees before the first consult, and most hormone and functional practices should. Send one lab-fee payment link right after the intake form, remind on day 2 and day 5, and book the consult once results are in. The consult is then spent on decisions, not on ordering tests.

Why collect lab fees before the first consult?

Collecting the lab fee first means the patient arrives at the first consult with results in hand. You spend the visit on a plan instead of ordering tests and booking a second visit. It also shows who is ready to start, because a paid lab fee is a stronger signal than a booked call.

The alternative costs you twice. A consult without labs usually ends in "let's get bloodwork and talk again," which adds a second visit and a week or more of waiting. Patients drift away in that gap.

The risk is the opposite problem: asking for money too early, before the patient trusts you. The fix is timing and wording, covered below.

Who should the patient pay: the lab or the practice?

There are three common models. The patient pays the lab platform directly, the practice pays and bills the patient, or the lab cost is bundled into one first-visit fee. Each works. The right one depends on whether you want to show lab prices and how much reconciling you want to do.

If your EHR orders labs directly, as OptiMantra does with connected labs, you can still use any of the three. The EHR handles the order and results. The payment model is a separate choice.

Rupa Health is now part of Fullscript. Fullscript says Rupa accounts will move to Fullscript in phases, with notice beforehand. If you are choosing a lab platform today, check which one you will end up on.

Can you add an interpretation fee to the lab order?

Yes. Both major lab platforms let you add your own fee, so the patient pays the test and your fee in one checkout. Show the fee as its own line with a plain name, such as "Lab review," so it isn't read as a markup on the test.

• Fullscript supports custom fees as a flat amount or a percentage, shown as separate line items. Fullscript keeps a 5% processing fee from the payout.
• Rupa lets you add your own fee for interpretation, a follow-up visit or phlebotomy after you connect a Stripe account. You are paid out once results are in.

Rupa's payout timing matters for cash flow. If a patient pays but never gets drawn, you don't receive the fee.

Where does the lab-fee link go in the patient journey?

The lab-fee link goes right after the intake form and before the consult is booked. The order is: inquiry, intake form, lab-fee payment, lab draw, results, consult. Each step should trigger the next one without anyone sending it by hand.

1. Inquiry. The patient asks a question or books a discovery call.
2. Intake form. One form covers history, symptoms and consent.
3. Lab-fee link. Sent automatically once the intake form is submitted.
4. Lab draw. The patient gets the requisition and picks a draw site.
5. Results. Results land in your EHR or lab platform.
6. Consult booked. The booking link goes out when results arrive, not before.

Some practices book the consult at the same time as the lab fee, for about two weeks out. That works if draws are fast in your area. If results often run late, you will spend time rescheduling.

When should you send the lab-fee link and the reminders?

Send the link within an hour of the intake form, while the patient is still thinking about it. Then remind on day 2 and day 5. After day 5, hand it to a person for one direct message, and close the file if there is no reply.

Keep texts free of test names and conditions. A lock-screen preview is not private. Our guide to payment links and HIPAA covers safe wording for links and receipts.

How do you word the lab-fee message?

Lead with why the labs matter to the patient, then the cost, then the link. The fee should read as the first step of their care, not as a sales charge. Name what they get: a panel, a review of results, and a consult that uses them.

For the full set of reminder and follow-up messages, see our patient follow-up templates.

What if a patient pays but never gets labs drawn?

Track it as its own status, "paid, not drawn," and follow up on day 3 and day 7 after payment. Most of these patients are stuck on something small: a draw site, fasting rules or a lost requisition. One direct message usually solves it.

If they still haven't been drawn after 30 days, offer a choice: a new requisition or a refund. Check your platform's rules first. Fullscript allows lab refund requests within 90 days of purchase, as long as the sample hasn't gone to the lab. If you pay upfront and rebill, you set the refund rule yourself.

What refund and expiry policy should you set?

Write a short policy and show it before payment. Say the lab fee is refundable until the sample is collected, and that an unused order expires after a set period. Match your dates to your lab platform's refund window so you are never refunding money you can't get back.

• Refundable in full before the sample is collected.
• Not refundable after the sample is collected or a kit is sent back.
• Unused orders expire after a set number of days. Pick a number that falls inside your platform's refund window.
• An interpretation fee is refunded with the lab fee if no results ever come in.

How do you track lab fees from intake to consult?

Track five statuses for every new patient: intake done, lab fee paid, drawn, resulted, consult booked. Each one is a date. The gaps between them show where patients drop off and which reminder needs work.

A spreadsheet works for the first 20 patients. After that, use your EHR's tags or a tool that updates the status from the payment and lab events. Keep clinical detail out of any tool that has not signed a BAA. Our list of tools that sign a BAA helps you check.

To see what each lost patient costs at each step, try the patient drop-off calculator. If you want this set up for your practice, request a free patient journey map.