Negotiating Better Lab/Imaging Prices for Patients

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It’s been quite an adventure navigating which laboratory company offers the best options for studies and pricing. I’ve discovered that working with a variety of lab providers is beneficial for patient care. Since I operate a Direct Primary Care practice without accepting insurance for services, I utilize patients’ insurance for labs/imaging, if available, and strive to secure competitive pricing for uninsured patients.

I’m currently in discussions with local labs to expand offerings for complex conditions like Mast Cell Activation Syndrome (MCAS) or Median Arcuate Ligament Syndrome (MALS), though this process will take time. Recently, I successfully negotiated special pricing with a local lab that bills me approximately one-third of their standard rates, allowing me to bill the patient directly (aka Client Billing). This arrangement relies heavily on trust between the patient and I. Occasional instances arise where patients forget their repayment agreements, sometimes due to expired credit cards. Trusting my intuition has been crucial, as not everyone is suited for this arrangement. Fortunately, this is rare. 

I’ve also stumbled upon a promising development: after discussing my lower client billing rates with another lab’s local representative, they agreed to match those rates within a week! This collaboration is particularly advantageous as it allows me to offer more comprehensive lab services locally for my patients.

In essence, informing lab and imaging centers about better pricing elsewhere can lead to mutually beneficial agreements (and price matching), benefiting both the companies and, most importantly, our patients.

(Editor’s Note: DPC News would like to welcome Dr. Soto as one of our new writers!)

About April Soto, MD

April Soto was born and raised in Guatemala to Puerto Rican Missionaries. She came to the US to attend university and medical school at University of California San Francisco. She completed her residency in Family Medicine at White Memorial Hospital in Los Angeles, Ca , a 1-year Fellowship in HIV Medicine at Los Angeles County-University of California, 2-year fellowship in Integrative Medicine through Academy of Integrative Health and Medicine in San Diego, Ca. She worked at Kaiser Permanent for 13.5 years in Family Medicine, Infectious Diseases, Family Medicine Surgical Services and served as the Wellness Champion for the Family Medicine Residents. Dr Soto is also trained in psychedelic services and offers Ketamine, Breathwork and Biofield Medicine/Energy Healing services for patients with mental health concerns. She enjoys complementing western medicine along with addressing the physical, mental, spiritual, and emotional needs of her patients as well. She meditates daily and enjoys time in nature. Boogie boarding alongside the surfers brings her great joy! She lives in Los Angeles, Ca with her beloved husband Chris.