Frequently Asked Questions


4PMD began when a group of like-minded physicians decided to combine their laboratory testing volume in order to secure discounted pricing they can offer patients, making these tests more affordable for self-paying patients. Many of the physicians within our cooperative specialize in preventative medicine and related practices including hormone replacement therapy, weight-management, nutrition, and evidence based interventional medicine. 4PMD supports these practices by providing custom lab test templates, continued education, peer to peer consulting, and practice enhancement. We also serve as a liaison with the laboratory which decreases the amount of time the doctor needs to spend communicating with the lab, allowing more time for the patient. The current conventional system does not provide adequate support for physicians seeking to learn and offer many preventative and interventional treatments. Our goal is to provide the service and support necessary to help doctors establish and sustain a cash practice with confidence. We pride ourselves to have the best prices available in most U.S. states (Except NY, NJ, MA, VT, HI, NH and RI). We are also committed to educating people about what blood tests mean via our resources and education pages.
  1. Contact the patient to confirm if they went to the PCS for specimen collection
  2. Request recollection. Additional draw fee may apply if using a PCS
  3. Obtain a partial refund for the specific test(s) if recollection is not desired.
  4. Send an email to orders@4pmd.com for assistance or to notify our support team which option you would prefer
Lab requisitions expire at 6 months; however, we recommend renewing requisitions at 90 days. There have been consistent issues with patient service centers not being able to locate an order in the Labcorp system that are older than 90 days.
Refunds can be requested for any lab test where the specimen has not been collected. Refunds must be completed within one year (12 months) of the order. No refunds will be issued beyond 12 months from the order date.
Patients must bring a photo ID along with their requisition to any Labcorp PSC. Although lab requisitions are available in the Labcorp system, we recommend that the patient still brings their requisition to mitigate any error at the lab.
LabCorp centers are typically open during business hours Mon-Fri. with some locations open Saturdays. No appointment is necessary but you can schedule an appointment on their website www.Labcorp.com. Scheduling an appointment may save wait time if the lab is busy. No additional charges will be required.
To find a lab near you, please click here:https://www.labcorp.com/wps/portal/insurer/findalab
  1. If tests are ordered using 4PMD.com, then results will be uploaded to your account dashboard
  2. If tests are ordered by fax or email, then all results will be uploaded to your Share File folder.
  3. (for clients that order via email or fax, all documents are uploaded into Share File. We typically upload only one preliminary report.)
  4. A notification will be sent to your email letting you know when a document has been uploaded.
One preliminary (incomplete) report will be uploaded prior to receiving complete results. Do not hesitate to contact 4PMD if you want to check on preliminary results for a specific test
Yes. With office and mobile phlebotomy collection 4PMD can customize the requisition to include printable labels for each specimen tube. A specimen collection guide will be provided with the requisition to outline the collection volumes, tubes needed, and required storing instructions. Please let us know if patient is fasting or not and if the draw is to be done that day or in future by typing note into Add Patient> patient notes. Please also list the anticipated date and time of draw if future date is requested.
Please let us know if patient is fasting or not and if the draw is to be done that day or in future by typing note into Add Patient> patient notes. Please also list the anticipated date and time of draw if future date is requested.
Unfortunately, due to how our lab cooperative is set up, LabCorp will not send a courier to your location to pick up specimens. The only options for specimen collection are outlined as follows:
  1. You can collect and deliver the specimen at the nearest PSC. For locations closest to please visit:https://www.labcorp.com/wps/portal/findalab/
  2. You can make an arrangement with a local clinic or hospital that has a LabCorp Account. Specimens should be collected and delivered to the clinic prior to their scheduled pick-up time. The specimen will be picked up from the clinic under their account, however 4PMD will be billed for the lab order as stated on the requisition. Labcorp does not charge for the courier service, therefore the clinic will not incur any additional fees for allowing your specimen to be picked-up at their location.
  3. A mobile phlebotomy service may be available in some areas. You may be able to schedule a traveling phlebotomist to visit the patient’s home or work to perform the draw and then drop the specimens at the nearest PSC. The phlebotomist will charge a separate fee (usually around $100 per patient). 4PMD does not currently work with a mobile phlebotomy service but we are working on finding one who can serve all of our clients across the US. It is important to understand that the phlebotomy service may need to have collection supplies (tubes, etc) provided. Be sure they are using the correct specimen containers.
The doctor or patient can set up an arrangement with a local clinic that has a Labcorp account to collect patient specimens at their location. The clinic may charge the patient a separate collection fee for this service. 4PMD will provide the requisition with labels for each specimen tube. The clinic administering the collection should provide all collection tubes and supplies.
Currently we are able to provide specific tubes and lab requisition templates. Just let us know what you need and where to ship. There is a $15 shipping fee per box. Expedited shipping will cost more depending on the type of shipping needed.
4PMD will not contact your patient. The laboratory requires the patient address for national laboratory reporting on some panels.
Recent state regulations have made it impossible for us to serve customers in those states. Physician billing, or client bill, is not allowed in those states leaving patients with the choice to use their insurance or pay full retail price for needed tests. Some patient’s cross state borders to access affordable lab services in a state that does not limit access. Contact your legislators to complain about laws that take choices away from people.
Hawaii and Vermont do not have lab locations.
There should not be an issue with someone going to an out-of-state laboratory to complete a blood draw. Should a patient service center representative need to verify the requisition or ordering physician information, they may contact 4PMD or the ordering physician for more information.
Yes. As long as the blood draw occurs in any of the states we serve there is no problem. Just let us know when you place your order that this is what you are planning to do.
All 4pmd requisitions should be billed to our 4PMD Client Account. Occasionally a PSC will automatically populate insurance information or accidentally select ‘bill to Patient’. If this occurs, please notify 4PMD. We will immediately handle all correspondence with the lab and send you documentation confirming that the billing issue has been resolved. If possible, please provide us with invoice number and date of service so that we can identify the specific order quickly.
The "standard" and most cost effective blood tests for Testosterone (total) and Estradiol use the methodology called electrochemiluminescence immunoassay (ECLIA) to analyze these hormones. Usually these methods are sufficient for measuring sex hormone levels in both men and women, however there is a more accurate methodology that can be used. Liquid chromatography/tandem mass spectrometry (LC/MS-MS) is a more accurate measurement and can be used for patients that have a smaller target range for hormones. For example, Estradiol in men should be measured using LC/MS since men since there is a small window to work with. The same applies to measuring total testosterone in women. The increased sensitivity and specificity that are achieved by LC/MS-MS are the more appropriate choice for these clinical situations. The LC/MS sensitive assay also has application in the evaluation of estrogen deficiency in men, menopausal women, fracture risk assessment in these populations, and increasingly, in therapeutic drug monitoring of low-dose female hormone replacement therapy or anti-estrogen treatment. In addition, this assay is used to monitor men on testosterone replacement therapy.
The only saliva-based test is cortisol. Others have not been proven to be reliable.
Yes, simply process multiple orders under the same patient name (profile only needs to be created once) and the orders will be supplied.
Patient’s can pull up the lab request form on their smart phone when they arrive to the PSC. The lab really just needs confirm demographics (name, date of birth), requisition number, prescribing physician and what account toc bill.
4PMD can perform all approved testing using the best available methodology. If you do not see a test that you would like to order, please let us know the test name and methodology so that we may add it to our available tests after establishing a discounted price for you. Please contact us with questions on specific tests regarding pricing, turnaround times, and test requirements.
Unfortunately, we cannot take insurance. This allows us to keep the lowest prices possible.
Most lab test results are available within 3-5 business days after you get your blood drawn. LC/MS based tests like sensitive estradiol require up to 10 business days. Lab test results may be emailed to you as they arrive. Times may vary depending on the location and volume during that time.

Resources


Reference ranges can vary between laboratories because each laboratory establishes a reference range using different data.

Reference ranges are constructed using an average of the test results received at a specific lab. Each lab may serve a different demographic which results in variations between the data collected.

Here is a study of lab reference range variations for serum testosterone.
Wide variability in laboratory reference values for serum testosterone.
J Sex Med. 2006 Nov;3(6):1085-9.

Wide variability in laboratory reference values for serum testosterone.
Lazarou S, Reyes-Vallejo L, Morgentaler A.
Harvard Medical School, Division of Urology, Beth Israel
Deaconess Medical Center, Boston, MA, USA.
INTRODUCTION: The laboratory determination of testosterone levels consistent with a diagnosis of hypogonadism is complicated by the availability of multiple testosterone assays and varying reference ranges.

AIM: To assess current laboratory practices regarding availability of testosterone assays and use of reference values.

METHODS: A telephone survey of 12 academic, 12 community medical laboratories, and one national laboratory.

MAIN OUTCOME MEASURES: Types of androgen assays offered and determination of reference values.

RESULTS: All of the academic and eight of the community centers performed total testosterone testing. Free testosterone was performed in-house by six of the 12 academic and one community center. Testing for bioavailable testosterone, free androgen index, and percent free testosterone was performed in-house by no more than two centers. There were eight and four different assays used for total and free testosterone, respectively. One national laboratory offered equilibrium dialysis measurement of free testosterone. Of the 25 labs, there were 17 and 13 different sets of reference values for total and free testosterone, respectively. The low reference value for total testosterone ranged from 130 to 450 ng/dL (350% difference), and the upper value ranged from 486 to 1,593 ng/dL (325% difference). Age-adjusted reference values were applied in four centers for total testosterone and in seven labs for free testosterone. All reference values were based on a standard statistical model without regard for clinical aspects of hypogonadism. Twenty-three of the 25 lab directors responded that clinically relevant testosterone reference ranges would be preferable to current standards.

CONCLUSIONS: Laboratory reference values for testosterone vary widely, and are established without clinical considerations.