Note: this help section is only applicable if your build is integrated with Quest. If you are not currently integrated with Quest but would like to become so, please contact firstname.lastname@example.org.
Once labs or scans have been added to a patient's chart, there are a few ways to initiate an electronic lab order to Quest. First, in the Open Orders block, you can right click on an order and select "Send Order to Quest Labs." Or check the box beside one or more labs and select "Send to Quest Labs" from the Manage Checked drop down menu.
Alternately, if the orders were added inside an encounter note, you can send from inside the encounter note, either via the right click menu or by selecting Send Orders to Quest Labs from the Plan menu (sends ALL orders associated with the note).
Completing Your Lab Order Using the Send Orders Pop Out
When you click Send, a pop up appears for you to enter more details. First you can indicate where the specimen will be collected - in your office and then sent to Quest, or at a Quest facility. If the patient will be going to Quest to deliver the specimen, a drop down menu appears for you to indicate approximately when the patient will be arriving. Do not change the default (Today) unless the patient will not be arriving for months. The lab order will be valid for 90 days and the patient can come in anytime during this period even if "Today" is selected as the arrival date. Note that the default selection for where specimens are collected - that is, which option is selected when the pop out window appears - is configurable for your practice.
If you are collecting the specimen to send to Quest, you will have the opportunity to print a label for the specimen when the order is sent and the system returns a requisition form (see below).
Next, you can indicate who Quest should bill - your practice, the patient, or the patient's insurance (available only if you havehealth insurance information on file for the patient). Again, which option is selected by default is configurable.
Then there are two notes fields - one for entering notes to the lab that will accompany the order, and one for entering notes to yourself that will be sent back along with the results. Note that for any results that you opt to show on the Patient Portal, the notes to yourself (righthand notes field) WILL be visible and the notes to the lab (lefthand notes field) MAY be visible.
For the orders themselves, the order and CPT code that you selected are shown on the left, and on the right are possible matches from Quest's proprietary lab coding system. If no matches are found or you do not see the test you're looking for in the suggested matches in the drop down menu, you can type to search by test name or Quest code. You can also look up Quest codes by test name, test code, CPT or keyword on Quest's website. If you manually select something other than the suggested match, you will be given the option to check a box (appears below the CPT code on the left) to default to the selected Quest test whenever that CPT code is ordered. You can also check a box to add notes (to the lab or to yourself, as in the general notes fields) for that particular order.
For a minority of lab orders, Quest asks for additional information. If this is the case for an order that you have selected, you’ll be presented with what are called Ask on Order prompts below the selected Quest test (for example, "SOURCE" below the Quest equivalent for the Urine Culture and Colony Count). Ask on Order prompts may require a valid entry for Quest to process your lab order.
After You Click Send - Lab Requisition Forms and More
When you click "Send," if the order fails to send for whatever reason, you will be returned to the ordering pop out and a message will appear indicating what the error was. Otherwise, the system will generate one or more PDF documents. This means that the order was successfully sent to Quest and you can print out the necessary forms for your patient.
At least one of the forms will be an electronic lab requisition form, and there may be more than one requisition form, depending on the labs ordered. The words "PSC Hold" in the upper right corner mean that you specified that the patient would go to Quest to give the sample. Otherwise, the requisition form will say "EREQ" (for electronic requisition). Quest has a copy on file and a copy of the requisition form is automatically saved in the Sent tab of the patient's documents block.
In rare cases, the system may also return an "Advance Beneficiary Notice of Noncoverage (ABN)" form. This form is only provided where the patient is a Medicare patient and bill to Medicare was selected in the ordering pop out and the selected test is not covered by Medicare for the diagnosis code provided. If an ABN is provided, the patient needs to read it and sign both copies. One is for the patient and one is for your files.
If you are collecting the specimen to send to Quest, you can print a label for the specimen by clicking on the small "Print Label" button just above and to the right of the requisition form. The label should open in a new tab.