Doctor, patient, insurer: why nobody has time to explain your lab results

In every visit there are three parties in the room: the patient, the medical record, and whoever pays. Everyone acts reasonably, and the patient still leaves with a lab report that nobody explained.

I'm building ZaZdorovie, an early-stage prototype that turns lab reports into clear summaries for patients and clinicians. It's not a medical device and has no revenue yet. Recently I watched a pitch from a Russian startup that turns doctor-patient conversations into medical records. Investors got most excited about one phrase: "insurance terror". Clinics fear a mistake in the paperwork more than a confused patient. That made me look at how the three links actually connect.

Link 1. The doctor: paperwork eats the visit

• For every hour of face time with patients, doctors spend nearly two more hours on the record and desk work (Sinsky et al., Ann Intern Med 2016).
• The record isn't bureaucracy for its own sake. It shows what was done, and it is what gets paid.
• That's why AI scribes that turn the conversation into notes are growing fast. The time they free up could go to explaining.

Link 2. The payer: pays and checks

• United States. In ACA Marketplace plans, insurers denied nearly 1 in 5 in-network claims in 2023 (KFF). In the American Medical Association survey, physicians and their staff reported about 13 hours a week spent on prior authorizations (AMA, 2024).
• Russia. In compulsory insurance (OMS), insurers and funds run medical-economic and quality reviews and can cut payment to clinics for defects in records (Ministry of Health order No. 231n of 19.03.2021). Voluntary insurance (DMS) has its own checks in each contract.

The result is the same everywhere: documentation wins over explanation, because documentation is what gets checked.

Link 3. The patient: has the result, not the meaning

• Patients forget 40–80 % of what they hear in a visit (Kessels, 2003).
• Results now reach the phone before a clinician looks at them. Among patients with abnormal results, 16.5 % felt more worried after reading them, compared with 5 % with normal results (Steitz et al., JAMA Netw Open 2023).
• When nobody explains, forums do. In 154 public complaints we collected, "nobody explained it" and "everyone says something different" appear in almost every topic, from ferritin to cholesterol.

Where the chain breaks

Who	What they lose	What helps
Patient	Doesn't understand the result or the next step; comes back with the same questions	Preparing for the visit, saying the plan back, getting it in writing
Doctor	Time spent explaining the same things; follow-up messages	Clear handouts and one consistent format for results
Payer and clinic	"Just to ask" visits; patients who never come back for follow-up	Transparent, consistent results and a plain-language explanation for the person

What lab explanations can and can't do for payers

I want to be precise here, because it's easy to overpromise.

What a transparent lab explainer can give:

• Reproducible interpretation. Every calculated index uses a published formula with a source. The same report always gives the same output, so anyone can check it.
• One format. Reports from different labs, languages and units become one table.
• A clear summary for the member after a check-up. Whether this reduces "just to ask" visits and calls is a hypothesis. It can only be proven in a pilot.

What it can't do:

• It doesn't review or fix the clinic's visit documentation.
• It doesn't protect a clinic from claim denials or payer audits.
• It doesn't judge whether treatment follows guidelines.
• It doesn't make medical decisions. The clinician does.

So it's a different job from AI scribes, and the two fit together: the scribe covers the conversation and the record, the lab explainer covers the results and the patient's understanding.

What you can do as a patient

1. Ask who will explain your results. Many insurance plans have a nurse line or a care coordinator.
2. Get copies of your results and keep them in one place, sorted by date. Trends matter more than one number.
3. Bring three questions: what is important, what to do before the next visit and when to retest, which symptoms mean "come back sooner".
4. Say the plan back in your own words before you leave.
5. Ask the insurer, not the clinic, what your plan covers.

Chest pain, shortness of breath at rest, sudden weakness or trouble speaking: call your local emergency number (911 in the US, 112 in the EU).

Where we are (honestly)

ZaZdorovie is an early-stage prototype, built by a solo founder, with no revenue and no paying clients yet. The working version is in Russian. It is not available to US patients. Outside Russia we offer it only as software licensed to clinics, labs, insurers' health programs and health-tech teams, running on their own servers, with patient-facing interpretation switched off where regulation requires it. It's an information tool, not a medical device.

If you work at a clinic, a lab, an insurer or an AI-scribe company and want to test whether clear lab explanations change anything measurable, write to me: [e-mail] · project page.

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This article is not medical, legal or insurance advice. Sources are linked in the text.

Disclosure: drafted with help from AI tools; the facts, numbers and sources were checked by the author.