# US 2019/0244688 A1 · Device for approving medical tests across a plurality of medical laboratories, medical providers, and lab payers and methods for using the same > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 2019/0244688 A1 - Document ID: US20190244688A1 - Status: Published application - Kind: A1 - Application number: 15/888,763 - Filed: 2018-02-05 - Published: 2019-08-08 - Earliest claimed: 2018-02-05 - Assignees: Optum, Inc. - Applicants: Optum, Inc. - Inventors: John L. WILSON; François CHARETTE - Web page: https://patentgrep.com/patent/US20190244688A1 ## CPC - G16H 10/40: for data related to laboratory analysis, e.g. patient specimen analysis - G16H 10/60: for patient-specific data, e.g. for electronic patient records - G16H 80/00: ICT specially adapted for facilitating communication between medical practitioners or patients, e.g. for collaborative diagnosis, therapy or health monitoring - G06Q 10/06395: {Quality analysis or management} - G16H 70/20: relating to practices or guidelines - G16H: HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA - G06Q: INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES; SYSTEMS OR METHODS SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES, NOT OTHERWISE PROVIDED FOR ## Abstract Provided is a lab clearinghouse device configured to efficiently and effectively approve medical tests across a plurality of medical laboratories, medical providers, and lab payers. The lab clearinghouse device is configured to communicate with a plurality of medical laboratories, medical providers, and lab payers to efficiently and effectively approve, direct, and manage medical tests. ## Claims ### Claim 1 A device for approving medical tests across a plurality of medical providers, a plurality of lab payers, and a plurality of laboratories, the device comprising a processor and a memory storing computer instructions that, when executed by the processor, cause the device to: receive a lab request from a lab request initiator, the lab request initiator being associated with at least one medical provider of the plurality of medical providers, wherein the lab request comprises an order for one or more medical tests to be performed; evaluate the lab request, wherein evaluating the lab request comprises determining the appropriateness of the lab request by comparing patient data, physician data, provider data, lab data, payer data, or a combination thereof to the lab request; and approve or deny the lab request based on the appropriateness of the lab request, wherein approving the lab request comprises: generating lab instructions associated with the lab request for performance of the lab instructions after determining that the lab request is appropriate, and transmitting the lab instructions associated with the lab request to one laboratory of the plurality of medical laboratories for performance of one or more corresponding medical tests, and wherein denying the lab request comprises transmitting a lab request denial if the lab request is determined not to be appropriate. ### Claim 2 (depends on 1) The device of claim 1, wherein the lab instructions specify the laboratory of the plurality of laboratories for performance of the lab instructions and the one or more medical tests to be performed by the laboratory. ### Claim 3 (depends on 1) The device of claim 1, wherein the appropriateness of the lab request is determined based on a degree of quality of the laboratory. ### Claim 4 (depends on 3) The device of claim 3, wherein the appropriateness of the lab request is determined based on a medical suitability of the medical tests to a patient's diagnosis, the patient being associated with the lab request. ### Claim 5 (depends on 3) The device of claim 3, wherein the appropriateness of the lab request is determined based on a completeness of the lab request, an error in the lab request, cost associated with the lab request, timeliness of a laboratory for performance of the one or more medical tests, location of the laboratory for performance of the one or more medical tests, or a combination thereof. ### Claim 6 (depends on 3) The device of claim 3, wherein the appropriateness of the lab request is determined based on an insurance policy of a patient associated with the lab request. ### Claim 7 (depends on 1) The device of claim 1, wherein the computer instructions, when executed by the processor, further cause the device to retrieve patient data, physician data, provider data, lab data, payer data, or a combination thereof from one or more external devices operated by one or more of the plurality of medical laboratories, medical providers, lab payers, or a combination thereof when evaluating the lab request, wherein evaluating the lab request is based on at least a portion of the patient data, physician data, provider data, lab data, payer data, or a combination thereof retrieved from the one or more external devices. ### Claim 8 (depends on 1) The device of claim 1, wherein the lab request denial comprises a suggested revised lab request. ### Claim 9 (depends on 1) The device of claim 1, wherein the computer instructions, when executed by the processor, further cause the device to receive a lab payment from the at least one lab payer of the plurality of lab payers prior to generating lab instructions associated with the lab request. ### Claim 10 (depends on 9) The device of claim 9, wherein the computer instructions, when executed by the processor, further cause the device to receive lab results from the at least one laboratory of the plurality of medical laboratories and transmit at least part of the lab payment to the at least one laboratory of the plurality of medical laboratories. ### Claim 11 (depends on 10) The device of claim 10, wherein the computer instructions, when executed by the processor, further cause the device to transmit the lab results to the lab request initiator. ### Claim 12 A method approving medical tests across a plurality of medical laboratories, medical providers, and lab payers, the method comprising: receiving, by a lab management circuitry, a lab request from a lab request initiator, the lab request initiator being associated with at least one medical provider of the plurality of medical providers, wherein the lab request comprises an order for one or more medical tests to be performed; evaluating, by an analytical engine, the lab request, wherein evaluating the lab request comprises determining the appropriateness of the lab request by comparing patient data, physician data, provider data, lab data, payer data, or a combination thereof to the lab request; and approving or denying the lab request based on the appropriateness of the lab request, wherein approving the lab request comprises: generating, by the analytical engine, lab instructions associated with the lab request for performance of the lab instructions after determining that the lab request is appropriate, and transmitting, by a communications interface, the lab instructions associated with the lab request to one laboratory of the plurality of medical laboratories for performance of one or more corresponding medical tests, and wherein denying the lab request comprises transmitting, by the communications interface, a lab request denial if the lab request is determined not to be appropriate. ### Claim 13 (depends on 12) The method of claim 12, wherein generating lab instructions comprises developing instructions specifying the laboratory of the plurality of laboratories for performance of the lab instructions and specifying the one or more medical tests to be performed by the laboratory. ### Claim 14 (depends on 12) The method of claim 12, wherein the appropriateness of the lab request is determined based on a degree of quality of the laboratory. ### Claim 15 (depends on 12) The method of claim 12, wherein the appropriateness of the lab request is determined based on a medical suitability of the medical tests to a patient's diagnosis, the patient being associated with the lab request. ### Claim 16 (depends on 12) The method of claim 12, wherein the appropriateness of the lab request is determined based on a completeness of the lab request, an error in the lab request, cost associated with the lab request, timeliness of a laboratory for performance of the one or more medical tests, location of the laboratory for performance of the one or more medical tests, or a combination thereof. ### Claim 17 (depends on 12) The method of claim 12, wherein the appropriateness of the lab request is determined based on an insurance policy of a patient associated with the lab request. ### Claim 18 (depends on 12) The method of claim 12, further comprising retrieving patient data, physician data, provider data, lab data, payer data, or a combination thereof from one or more external devices operated by one or more of the plurality of medical laboratories, medical providers, lab payers, or a combination thereof, wherein evaluating the lab request is based on at least a portion of the patient data, physician data, provider data, lab data, payer data, or a combination thereof retrieved from the one or more external devices. ### Claim 19 (depends on 12) The method of claim 12, wherein the lab request denial comprises a suggested revised lab request. ### Claim 20 A computer program product is provided comprising a non-transitory computer readable medium having computer program instructions stored therein, said computer program instructions when executed by a processor approve medical tests across a plurality of medical providers, a plurality of lab payers, and a plurality of laboratories, by causing the computer program product to: receive a lab request from a lab request initiator, the lab request initiator being associated with at least one medical provider of the plurality of medical providers, wherein the lab request comprises an order for one or more medical tests to be performed; evaluate the lab request, wherein evaluating the lab request comprises determining the appropriateness of the lab request by comparing patient data, physician data, provider data, lab data, payer data, or a combination thereof to the lab request; and approve or deny the lab request based on the appropriateness of the lab request, wherein approving the lab request comprises: generating lab instructions associated with the lab request for performance of the lab instructions after determining that the lab request is appropriate, and transmitting the lab instructions associated with the lab request to one laboratory of the plurality of medical laboratories for performance of one or more corresponding medical tests, and wherein denying the lab request comprises transmitting a lab request denial if the lab request is determined not to be appropriate.