INSURANCE-COMPLIANT ELECTRONIC ORDERING OF BIOLOGICAL SAMPLE TESTING

1 . A computer implemented method of ordering a laboratory test for a biological sample collected from a patient, the method comprising:

obtaining, from a data store, multiple sets of payor-specific ordering guidelines;

obtaining, from a graphical user interface, an indication or a payor identity;

selecting, with a payor-compliance logical circuit, one of the sets of payor-specific ordering guidelines based on the indication of the payor identity;

displaying, on the graphical user interface, ordering guidelines from the set of payor-specific ordering guidelines; and

obtaining, from the graphical user interface, a set of patient-specific data required by the payor to issue a reimbursement for the laboratory test based on the selected set of payor-specific guidelines.

2 . The computer implemented method of claim 1 , wherein the payor-specific ordering guidelines comprise a medical necessity flag, a pre-screening flag, a frequency limit flag, or a list of payor-approved laboratory test types.

3 . The computer implemented method of claim 1 , wherein the biological sample comprises urine, blood, or oral fluid.

4 . The computer implemented method of claim 1 , wherein the laboratory test comprises a drug test.

5 . The computer implemented method of claim 1 , wherein the obtaining the indication of payor identity comprises displaying, on the graphical user interface, a list of available payors, and obtaining a user selection of a desired payor.

6 . The computer implemented method of claim 2 , further comprising:

setting the medical necessity flag to true if identifying a medical necessity is required by the payor identified by the indication of the payor identity;

displaying, on the graphical user interface, a medical necessity input field;

obtaining, from the graphical user interface, a user description of medical necessity entered into the medical necessity input field;

storing, in the data store, the user description of medical necessity;

transmitting an order for the laboratory test after obtaining the user description of medical necessity; and

transmitting a request for reimbursement to the payor, the request for reimbursement comprising the user description of medical necessity.

7 . The computer implemented method of claim 2 , further comprising:

setting the pre-screening flag to true if pre-screening is required by the payor identified by the indication of the payor identity;

displaying, on the graphical user interface, a pre-screening indicator;

obtaining a pre-screening criteria indicating information about a pre-screening test of the biological sample;

storing, in the data store, the pre-screening criteria;

transmitting an order for the laboratory test after obtaining the pre-screening criteria; and

transmitting a request for reimbursement to the payor, the request for reimbursement comprising the pre-screening criteria.

8 . The computer implemented method of claim 2 , further comprising:

setting the frequency limit flag to a payor-specific frequency threshold if a payor-specific frequency threshold is required by the payor identified by the indication of the payor identity; and

displaying, on the graphical user interface, the payor-specific frequency threshold and an indication of a frequency at which the laboratory test had been performed for the patient.

9 . The computer implemented method of claim 8 , further comprising displaying, on the graphical user interface, a warning message if the indication of the frequency at which the laboratory test had been performed for the patient is equal to or exceeds the payor-specific frequency threshold.

10 . The computer implemented method of claim 2 , further comprising:

displaying, on the graphical user interface, a warning message if the laboratory test does not match any of the payor-approved laboratory test types.

11 . A system for ordering a laboratory test for a biological sample collected from a patient, the system comprising:

a data store, a payor-compliance logical circuit, and a graphical user interface, wherein the payor-compliance logical circuit comprises a processor and a non-transitory medium with computer executable instructions embedded thereon, the computer executable instructions configured to cause the processor to:

obtain, from the data store, multiple sets of payor-specific ordering guidelines;

obtain, from the graphical user interface, an indication or a payor identity;

select one of the sets of payor-specific ordering guidelines based on the indication of the payor identity;

display, on the graphical user interface, ordering guidelines from the set of payor-specific ordering guidelines; and

obtain, from the graphical user interface, a set of patient-specific data required by the payor to issue a reimbursement for the laboratory test based on the set of payor-specific guidelines.

12 . The system of claim 11 , wherein the payor specific ordering guidelines comprise a medical necessity flag, a pre-screening flag, a frequency limit flag, or a list of payor-approved laboratory test types.

13 . The system of claim 11 , wherein the biological sample comprises urine, blood, or oral fluid.

14 . The system of claim 11 , wherein the laboratory test comprises a drug test.

15 . The system of claim 11 , wherein the computer executable instructions are further configured to cause the processor to display, on the graphical user interface, a list of available payors, and obtaining a user selection of a desired payor.

16 . The system of claim 12 , wherein the computer executable instructions are further configured to cause the processor to:

set the medical necessity flag to true if identifying a medical necessity is required by the payor identified by the indication of the payor identity;

display, on the graphical user interface, a medical necessity input field;

obtain, from the graphical user interface, a user description of medical necessity entered into the medical necessity input field;

store the user description of medical necessity in the data store;

transmit an order for the laboratory test after obtaining the user description of medical necessity; and

transmit a request for reimbursement to the payor, the request for reimbursement comprising the user description of medical necessity.

17 . The system of claim 12 , wherein the computer executable instructions are further configured to cause the processor to:

set the pre-screening flag to true if pre-screening is required by the payor identified by the indication of the payor identity;

display, on the graphical user interface, a pre-screening indicator;

obtain a pre-screening criteria indicating information about a pre-screening test of the biological sample;

store the pre-screening criteria in the data store;

transmit an order for the laboratory test after obtaining the pre-screening criteria; and

transmit a request for reimbursement to the payor, the request for reimbursement comprising the pre-screening criteria.

18 . The system of claim 12 , wherein the computer executable instructions are further configured to cause the processor to:

set the frequency limit flag to a payor-specific frequency threshold if a payor-specific frequency threshold is required by the payor identified by the indication of the payor identity; and

display, on the graphical user interface, the payor-specific frequency threshold and an indication of a frequency at which the laboratory test had been performed for the patient.

19 . The system of claim 18 , wherein the computer executable instructions are further configured to cause the processor to display, on the graphical user interface, a warning message if the indication of the frequency at which the laboratory test had been performed for the patient is equal to or exceeds the payor-specific frequency threshold.

20 . The system of claim 12 , wherein the computer executable instructions are further configured to cause the processor to display, on the graphical user interface, a warning message if the laboratory test does not match any of the payor-approved laboratory test types.