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Guide to Reference Laboratory Request for Proposals

Based on conversations with community-based laboratories around the country, we have developed this document that details some basic tips and common questions to consider when writing your organization’s next request for proposal. The questions are designed to elicit responses that not only distinguish competing laboratories, but they gather information about a reference laboratory that will help achieve your organizational goals.  

View Pre-RFP Checklist and Questions

Pre-RFP Checklist

Compile a complete test list from every laboratory to which you refer certain tests.

Many times, the RFP process will only address a primary laboratory (or laboratories) due to more routine testing and higher volumes. Make sure your list includes all tests sent to niche or “boutique” laboratories, as these tests represent the highest priced tests in your laboratory’s budget.  

Leverage multiple sources of information to formulate a complete list of all tests that you refer out to other laboratories.

There is no single source of information that can offer a complete view of your laboratory test list. Sources should include your laboratory information system, manual ordering processes, and sendouts to each reference laboratory, big or small. Also, make sure that all sendouts, including the low volumes, are accounted for in your final list.  

Validate the utilization report from all your incumbent laboratories.

Using utilization reports may not capture tests that have been brought in-house. Remove custom profiles and obsolete tests or tests that will remain local (e.g., state newborn screening, blood bank testing). Make sure that any testing that is currently third-party billed is removed, as it will distort the response. Also, make sure that the entire test panel is captured—not just initial screens.  

Provide the data in a format that replicates your ordering practices.

Many times, laboratory RFPs list all the tests, components, reflexes, etc. in numerical or alphabetical order. This can hinder your evaluation efforts, as it makes it more difficult to accurately analyze the data.  

Provide the reference laboratory orderable test codes, Current Procedural Terminology (CPT) codes, testing location, and methodologies for each of your tests.

Request that participating laboratories provide this same information when they return their proposals. This will aid you in identifying how your tests have been matched and allow you to review and decide if the proposed test from the reference laboratory is acceptable for your physicians.  

Ask who will be doing the matching at the participating laboratory to make sure a trained medical professional is providing the most clinically appropriate match.

Be aware that many participating laboratories rely on non-clinical reviewers or “black box” databases. As a result, these approaches tend to focus on providing the lowest per-test price as opposed to the most clinically appropriate match. Make sure that you, with your medical staff, evaluate all test matches to assure that participating laboratories meet your patient-care needs.  

Request for Proposal Questions

  1. What is your business model, and how does it support the goals of our laboratory and organization?
  2. Are you part of an integrated medical system or affiliated with another organization?
  3. Please describe how your company distinguishes itself from competitors.
  4. Describe in detail your quality-management program, in particular, monitoring and documenting accuracy and reliability of results as well as continuous quality-improvement processes.
  5. List all the client-service metrics tracked and used by your company to monitor quality and performance. Include examples of reports.
  6. Describe your licensure and accreditations.
  7. How do you ensure clinical utility of current tests and any new tests?
  8. What dedicated reference laboratory support will be assigned to our facility?
  9. What is your escalation process for complicated inquiries?
  10. Describe your customer service process, including services provided and service hours. How are inquiries handled (automated system or a live person answering the phone)? What percent of the time is your customer service staff able to service without transferring?
  11. Do you have physicians available on staff to consult directly with the referring-site physicians? Describe the available consultative services and the procedure for accessing those services.
  12. Do you have a secure web-based mechanism for ordering tests, reporting results, and managing information? Fully describe your network protocol and connectivity requirements.
  13. Describe the implementation process of a new interface and include a sample timeline. Describe the financial assistance you will provide to build the required laboratory information system (LIS) interfaces.
  14. Detail the specimen pickup and transport services, including costs.
  15. How is your lab prepared for emergencies or other contingencies?
  16. What systems have you put into place to ensure the safe shipment and arrival of specimens at the testing laboratory? What technology does your organization use to communicate, monitor driver performance, and track items in transit?
  17. Identify the collection and transportations supplies you provide to clients.
  18. Is there an expedited or stat process?
  19. How will you prepare our laboratory for the transition from fee-for-service to value-based?
  20. As our reference laboratory partner, how can you help to keep testing within our system and drive down sendout costs?
  21. Has you clinical practice implemented algorithms to ensure the most appropriate test is performed?
  22. Describe your ability and commitment to assist our laboratory in developing or expanding a laboratory outreach program. Include any associated fees for outreach support.
  23. How will you drive testing to our hospital from our physician practices?
  24. Outline the assistance your organization will provide in marketing services to our clients, including any associated fees.
  25. Describe any continuing-education programs and opportunities, publications, and other education materials (and associated costs) offered. Note if accredited by the ACCME to provide continuing medical education for physicians and an ASCLS PACE-approved provider for clinical laboratory professionals.
  26. How else will your reference laboratory help our organization achieve its goals?
Andy Tofilon

Andy Tofilon

Andy Tofilon is a Marketing Segment Manager at Mayo Clinic Laboratories.