How to get lab work ordered through a telehealth visit

Your telehealth clinician sends a lab order, you get your blood drawn at a nearby patient service center such as Quest Diagnostics or Labcorp, or use an at-home kit where the test allows it, and the results come back to the clinician and usually to your own online portal. The whole process can take a few days. Getting the details right, such as fasting and time of day, is what makes the results worth having.

Why a telehealth plan often needs labs

A video visit can cover your history, symptoms and goals in depth. It cannot measure your blood. For many treatments, a careful clinician wants baseline numbers before starting and checks again at intervals afterward.

Examples include confirming low testosterone with properly timed morning tests before considering therapy, and then monitoring blood counts once treatment starts. Our post on testosterone blood testing explains why the timing matters. Weight management medication may call for a metabolic panel or an A1c. Peptide therapy has its own considerations, covered in lab work before peptide therapy.

A practice that starts these treatments without asking for any lab work, where the evidence calls for it, is skipping a step.

Step by step

1. The clinician places the order

After your visit, the clinician sends an electronic order to the lab or gives you a requisition, a printable or digital form listing the tests, your details and the ordering clinician. Ask which you will get, and make sure it lists the tests you discussed.

2. You choose a draw site

Quest and Labcorp both run large networks of patient service centers across Michigan, Illinois and California, and both offer online appointment booking. Hospital outpatient labs and some independent labs are other options. If you are using insurance, check that the lab is in your plan's network. Using an out-of-network lab is a common source of unexpected bills.

3. You prepare

Follow the instructions you are given exactly. Common ones include:

• Fasting, usually 8 to 12 hours with water only, for some glucose and lipid tests.
• Time of day, especially early morning for testosterone and some other hormones.
• Medication timing, for example whether to take a dose before or after the draw.
• Supplements, since high-dose biotin, found in many hair and nail supplements, can interfere with some lab assays. Tell your clinician what you take.

Drink water unless told otherwise. Being well hydrated makes the draw easier.

4. You go to the draw

Bring photo ID, your requisition or order confirmation, and your insurance card if you are using insurance. The draw itself usually takes a few minutes.

5. Results come back

Most routine results are ready within a few days. Some specialized tests take longer. The results go to the ordering clinician and, usually, to you through the lab's portal or the practice's portal.

At-home kits

At-home kits typically use a finger-prick sample, either as dried blood spots on a card or in a small collection tube you mail back. Some companies send a mobile phlebotomist to draw blood at your home, which is a different thing and generally equivalent to a draw at a service center.

Finger-prick kits are convenient and work well for some tests. They are less suitable for others, and results can be affected by how the sample was collected. Collection problems such as too little blood or a damaged sample sometimes mean starting over. Before buying a kit, ask your clinician:

• Will you accept results from this kit for the tests you need?
• Are all the tests I need available this way?
• Is this kit's laboratory certified under CLIA, the federal standard for clinical labs?

If the answer to any of these is no, a draw at a service center is usually the better choice.

Paying for labs

Labs are often billed separately from the telehealth visit. Even if your visit is cash-pay, lab tests ordered by your clinician can often be billed to your insurance if your plan covers them and the lab is in network, subject to your deductible. If you are uninsured or would rather not use insurance, many labs offer self-pay pricing. Ask for the price of each test before the draw. If you are paying out of pocket, the federal No Surprises Act entitles you to a good faith estimate for scheduled services.

For how visit payment and insurance interact, see does telehealth take insurance?

Reading your results

Federal information-sharing rules under the 21st Century Cures Act mean many results are now released to patients very quickly, sometimes before your clinician has seen them. That is good for transparency, and it can be unsettling.

Keep a few points in mind:

• Reference ranges describe a population, not you. A value slightly outside the range is often not significant, and a value inside it is not always ideal for you.
• One reading is a snapshot. Many tests vary with time of day, recent meals, illness, sleep and exercise.
• Your clinician interprets results in the context of your history, symptoms and medications.

Ask how the practice will follow up: a message, a scheduled visit or a call. A clinician who orders labs should also review them with you, as discussed in how often you need follow-up visits.

Keep your own copies

Download and save your results. They are useful for future clinicians and for tracking trends over time, and you have a right to them under HIPAA. If you are starting weight management or hormone therapy, having your baseline numbers on hand makes every later conversation more useful.

Questions patients ask us

Can a telehealth doctor order blood work?

Yes. A licensed telehealth clinician can order lab tests the same way an office clinician does, either electronically to a lab or with a requisition form you take to the draw site. You then have your blood drawn at a patient service center or, for some tests, use an at-home collection kit. The results go back to the clinician.

Where do I go to get my blood drawn?

Most people use a patient service center run by a national lab such as Quest Diagnostics or Labcorp, both of which have many locations in Michigan, Illinois and California. Hospital outpatient labs and independent labs are other options. If you are using insurance, check that the lab is in your plan's network to avoid unexpected bills.

Do I need an appointment for a lab draw?

Not always, but it usually helps. Quest and Labcorp both offer online appointment booking, which tends to shorten the wait compared with walking in. If your test needs to be drawn early in the morning, such as testosterone, book the first available morning slot.

Do I need to fast before my blood test?

Only if your clinician tells you to. Some glucose and lipid tests call for fasting, typically 8 to 12 hours with water only. Other tests do not require it. Follow the instructions you were given, and ask if they are unclear. Drinking water is usually fine and makes the draw easier.

Are at-home blood test kits accurate?

They work well for some tests and less well for others, and results can be affected by how the sample was collected. Before buying one, ask your clinician whether they will accept that kit's results for the tests you need, and check that the kit's laboratory is CLIA-certified. A mobile phlebotomist draw at home is generally equivalent to a service center draw.

Can supplements affect my lab results?

Yes. High-dose biotin, common in hair, skin and nail supplements, can interfere with some laboratory assays, including some hormone tests. Tell your clinician about every supplement you take, and ask whether to pause any before your draw. Do not stop a prescribed medication without asking first.

How long do lab results take?

Most routine results come back within a few days. Some specialized tests take longer. Results go to the ordering clinician and usually to you through a lab or practice portal. Ask your clinician how and when they will review the results with you.

Why did my results show up before my doctor called?

Federal information-sharing rules under the 21st Century Cures Act mean many results are released to patients quickly, sometimes before the clinician has reviewed them. A value outside the reference range is not automatically a problem, and one inside it is not always ideal for you. Wait for your clinician's interpretation unless you feel unwell.

Will insurance pay for labs ordered by a cash-pay telehealth practice?

Often, if your plan covers the tests and you use an in-network lab, subject to your deductible and coinsurance. The visit and the lab are billed separately. If you are uninsured or prefer not to use insurance, many labs offer self-pay prices. Ask for the price of each test before your draw.

Can I use lab results from my primary care doctor?

Often, if they are recent and include the tests your telehealth clinician needs. Send them before your visit. Some treatments require results taken at a specific time of day or under specific conditions, so your clinician may still ask for new tests. Recent results can still reduce how much new testing you need.