Industry Insights
Roundtable Discussion: Laboratory Billing Solutions and the Lab RCM Process
January 2, 2025
For those who may have missed it, the April 2023 Issue of CAP Today featured a Bob McGonnagle-led roundtable discussion on laboratory billing. As usual, Bob did a great job as moderator as experts in the field of laboratory revenue cycle management (lab RCM) discussed various topics including:
- What’s required and where things stand with the No Surprises Act
- Ongoing issues with prior authorizations, denials, and slow payments
- Lab billing processes and digital pathology
For those still interested in reading this insightful content, click below for the full article.
CAP Today: In Lab Billing, No Surprises and Other Complexities
LigoLab’s Fully Integrated Laboratory Billing Solutions
LigoLab CEO Suren Avunjian participated in the discussion and was asked if LigoLab customers were having issues matching estimates for service against what is ultimately billed to patients. He responded that LigoLab’s all-in-one laboratory information system with advanced laboratory billing solutions has the infrastructure and rule engine customers need to manage such a scenario. He added that having laboratory information systems with lab revenue cycle management modules creates a fully integrated single source of truth that allows customers to manage this example from multiple angles.
Learn More: Clinical Laboratory Management Solutions for Lab Revenue Cycle Management (Lab RCM)
A bit later, Avunjian was asked how the LigoLab Informatics Platform helps pathology practices overcome staffing issues. Here’s his full response to those questions (the CAP Today version was edited because of spacing constraints):
“One of our approaches to solving staffing issues involves leveraging rule and automation engines designed to adapt to any lab operation, whether large or small. Specifically, this approach allows our partners to handle workflow-related challenges via pre-loaded rule sets,” said Avunjian before providing the following example. “Payer mapping combined with local and national coverage determination (LCD & NCD) rules capture potential denials up front. Transforming the denial aspect of lab billing workflows into a “front end” laboratory billing process results in a first-pass pay rate as high as the upper 90th percentile.”
“Our primary focus for lab billing automation is not to reduce staff but to increase compliance and revenue acceleration and collection. By severely lowering the rate of claim denials and appeal work, we can help our partners eliminate unnecessary delays and likely money left on the table,” continued Avunjian. “Driving maximum transparency and attacking the challenge with a large rule set that can capture potential denials before they are submitted is a healthier and more sustainable approach to the RCM process. Whether the laboratory is small or large, full system automation and configurability are keys to addressing the laboratory operators’ challenges. The solution is to comply with payer requirements via maximum streamlined manual operations.
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Consolidation and Lab Billing Collections Discussed
The conversation next turned toward pathology practice consolidation and whether or not consolidation will help with lab billing and collection problems. The immediate future of digital pathology was also discussed with McGonnagle asking the roundtable if the new CPT codes for digital pathology would make an immediate impact.
Learn More: Digital Pathology: The Future is Here
The group agreed that there were many variables to consider, including pathologist burnout. Avunjian then suggested the right pathology lab software could make a difference and help efforts to address the burnout problem.
Learn More: Best Pathology Lab Reporting Software - 2025 Buyers Guide and Checklist
“Simplifying pathologists’ daily work as much as possible and adding laboratory information system software automation to remove the redundant steps and clicks can significantly impact productivity and job satisfaction,” he said. “AI and digitalization of the slides and workflow will help relieve the staffing shortages.”
Learn More: How LIS Software Helps Pathologists Sign Out Anatomic Pathology Cases Faster
The roundtable discussion ended with all participants afforded one more chance to weigh in with their future thoughts for the industry. For Avunjian, end-to-end LIS system software solutions remain the key to future success in the pathology lab space, a fact learned after several years of work in a private laboratory IT department.
“The lesson learned is that the most successful laboratories must transform into technology companies,” he said. “We took the tough route and tried to build as much as we could in-house (at the private lab), but at some point the cost of development and scope of the implementation got exponentially more complex going from innovation to maintenance mode. These days there are laboratory information system vendors who can help with this transformation. You have to choose your battles and select partners wisely because you can’t be a great lab and an exceptional software company. You have to choose one or the other.”
The April issue also has a section that lists Laboratory Billing/Accounts Receivable/RCM Systems and system features. Here’s a link to that listing.
CAP Today: Laboratory Billing/Accounts Receivable/RCM Systems
LigoLab’s lab RCM solution is included in the listing.
To learn more about LigoLab’s advanced laboratory billing solutions contact a lab billing product specialist or continue reading the links below.
How Cole Diagnostics Streamlined Client Billing with LigoLab’s LIS & RCM Platform
Leveraging LIS & RCM Integration to Improve the Laboratory Billing Process
The Connected Laboratory: A New Approach to Laboratory Billing Services
On-Demand Webinar: Overcoming Challenges in Clinical Labs with Advanced Laboratory Information System Technology
Laboratory leaders face ongoing challenges, including staffing shortages, reimbursement cuts, customer turnover, and evolving regulatory demands, all while aiming to achieve growth and profitability.
The most effective strategy for tackling these issues starts with integrating advanced rules and automation into laboratory workflows, powered by modern laboratory information system software technologies.
Join us for this on-demand webinar featuring Corey Handelsman, Director of IT at Summit Pathology, and Allison Still, LIS Product Specialist at LigoLab.
Together, they explore how advanced LIS system capabilities and data-driven insights can enhance operational efficiency. Don’t miss this opportunity to learn from industry experts how to harness medical LIS technology to address common laboratory challenges and drive success.
Watch On-Demand: Leverage LIS System Rules, Automation, and Data Analytics to Increase Efficiency and Cut Costs
