Optimal - The Blog

November 11, 2021

Everything You Need to Know About Ordering Blood Tests

Ordering blood tests for Functional Blood Chemistry Analysis (FBCA)

Everyone benefits from blood chemistry analysis but not everyone knows how to obtain the labs needed for a comprehensive assessment.
  • Blood tests can be ordered prior to a client’s first visit and be reviewed at that visit or
  • Blood tests can be ordered at the first visit and reviewed at a follow-up visit.

Order through insurance

  • Using insurance may limit coverage or availability of some labs (e.g., some insurance companies won’t cover homocysteine stating that it is “investigational” despite research supporting it as an important cardiovascular marker).
  • Must be performed by an “in-network” lab or the client may be charged at a higher rate than what is charged through direct-access testing (DAT).
  • Requires a licensed healthcare practitioner permitted to order labs (e.g., MD, DO, DC, ND, DDS, PA, NP).
  • Some states allow licensed dietitian nutritionists, clinical nutrition specialists, or registered dietitian nutritionists to order labs.

Order through direct access testing (DAT)

Clients can order their own blood work directly through third-party direct-access labs or with main labs such as Quest or LabCorp. They then provide the practitioner with results. Clients pay for all tests directly, and insurance is not involved. Unfortunately, some states do not allow direct-access ordering, so be sure to check with each company directly.

Healthcare practitioners can set up an account and order labs for clients through a direct-access service as well. This option is convenient as the practitioner can access client labs directly. This service may be referred to as direct-to-consumer testing or consumer-driven testing. Though it is possible for individuals to order and attempt to interpret their own labs, it is decidedly preferable for a health practitioner to review the results.

Labs can be charged to the client directly or charged to the practitioner and reimbursed by the patient. It is appropriate to charge the client for clinical time and review time used for the FBCA.

Direct-access testing companies are obliged to send results to a CLIA-certified lab for processing. Some companies allow practitioners to set up specialty panels, and some can export results directly into FBCA software.

Examples of direct-access companies:

  • AnyLabTestNow.com
  • Directlabs.com
  • Pixel.labcorp.com
  • Questdirect.questdiagnostics.com
  • Ultalabtests.com
  • WalkInLabs.com

What tests to order

Here are some examples of biomarker panels:


Basic Panel

Basic Plus



Custom Sample

CBC (differential and platelets)

Comprehensive Metabolic Panel

Lipid Panel with Ratios


Basic panel


Bilirubin fractions




Iron, TIBC




Uric acid

Basic Plus



25(OH) Vitamin D


T3 total and free

T3 uptake

T4 total and free




Advanced panel


Fibrinogen activity

T3, reverse

Thyroid peroxidase and thyroglobulin antibodies

Basic panel


DHEA sulfate






Iron, TIBC

Magnesium, RBC

Omega-3 and -6 fatty acids

Omega-3 Index

25(OH) Vitamin D

T3, free

CLICK HERE for a comprehensive view of the panels recommended by Dr. weatherby and Optimal DX

CLICK HERE for the ODX Biomarker Panels in PDF format

How long will the results take?

Some results may be available within 24 hours, but many panels take 2-3 days for results or possibly longer for more complex panels such as hormone panels.

Reviewing blood tests using FBCA

Devote at least 30 minutes of clinical time for a FBCA review.
Obtain past blood test results if possible and incorporate them into the assessment to help detect trends toward or away from dysfunction.
Be aware when comparing results from different labs that methodologies and standard reference ranges may differ.

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Overview of FBCA process

Determine if blood work will be ordered prior to the client’s initial visit or ordered at the initial visit and reviewed in follow-up.

  1. Order through insurance if applicable.
    • Obtain lab results
      • Biomarkers covered by insurance may be limited, which can affect the scope of the FBCA.
    • The client can provide past labs for comparison.
    • The client can order labs via direct-access companies.
    • Practitioners can set up an account with a direct-access company and order labs for clients.
  1. Enter results into FBCA software>
    • Import results from participating direct-access companies.
    • If importing is not available, then results must be entered manually.
    • Be sure to choose the appropriate lab units, i.e., Conventional US or International System of Units (SI).
  2. Prepare reports to be reviewed. The practitioner report should be reviewed prior to the visit and the patient report can be reviewed during the visit.
  3. Provide ample clinical time to review the report, answer questions, and determine the plan of care going forward.
  4. Provide a digital or printed copy of the patient report if desired.
  5. Set up follow-up blood work and visits.
Tag(s): ODX

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