Industry Insights
Top Laboratory Trends for the New Year
December 19, 2024
As we head into the new year, now’s a good time to reflect on the past several months and consider what’s on the horizon.
Yes, the future is unpredictable, but that doesn’t mean we as active participants in the medical laboratory industry should stop making them.
With that in mind, we highly recommend laboratory professionals (if they haven’t done so already) check out the “17 Laboratory Predictions for 2025” in Clinical Lab Products’ October/November issue.
Like last year CLP consulted with various industry experts and asked them to name their top lab trends for the new year.
What follows is a summary of takeaways from the CLP article.
More Growth in Automation and AI Predicted
Not surprisingly automation and AI emerged as the leading trends for the second consecutive year. Alongside them, new trends driven by demographic shifts, advancements in laboratory information systems (LIS systems) and other testing technology, and an increasing focus on emerging disease states were also discussed.
Top Trends:
Automation and AI:
- These dominant trends will continue to be critical for addressing workforce shortages and improving lab efficiency.
- The adoption of advanced robotics and AI-powered diagnostics is expected to accelerate.
- AI applications include faster operations, predictive analytics, laboratory billing (lab revenue cycle management) automation, and precision in clinical outcomes.
Collaborative Innovation:
- Enhanced partnerships between research institutions, pharma, and medtech companies to develop diagnostics and therapies.
Specialized Testing:
- Increase in tests for antimicrobial resistance, allergies, autoimmune diseases, and molecular diagnostics.
AI and the Power to Reshape Laboratory Revenue Cycle Management
LigoLab CEO Suren Avunjian, a recognized thought leader in the pathology lab software and laboratory informatics space, participated in the CLP article and emphasized the transformative potential of AI in revolutionizing the laboratory billing process in the coming year.
As an advocate for innovation, Avunjian highlighted specific AI-powered practices reshaping the landscape and quickly becoming advanced laboratory billing solutions.
Automation for Data Entry and ICD/CPT Coding:
- AI-powered systems can automatically populate and extract relevant information from laboratory information systems and assign appropriate ICD and CPT codes for enhanced lab billing. AI algorithms and Machine Learning (ML) technology can learn from historical data to improve coding accuracy with every case.
Interpretation of Contracts and Rule Building for Payer Management:
- One of the most intricate challenges in laboratory billing is managing contracts with payers, including insurance companies and government programs. These contracts often contain complex terms, varying reimbursement rates, and detailed clauses that can be difficult to interpret and enforce manually. AI and ML technologies can automate the interpretation of these contracts, build actionable lab billing rules, and detect payers' mispayments or underpayments.
- Once the contract terms are extracted, AI systems can automatically generate lab billing rules aligning with each payer's requirements. These rules can be integrated into the laboratory billing system, ensuring all claims comply with contractual obligations.
- AI can continuously monitor incoming payments and compare them against expected amounts based on the contractual agreements and services rendered. AI can flag payment mistakes such as underpayments by analyzing payment patterns and discrepancies,
- AI analytics can provide laboratories with data-driven insights into payer behaviors, common areas of dispute, and financial impacts of specific contract terms. This information is invaluable during contract negotiations.
Predictive Analytics and Denial Management:
- AI and ML models can predict which claims are likely to be denied (based on historical data) thus allowing lab billing teams to address potential issues before submission, increase claim acceptance rates, and reduce the time spent on resubmissions.
Real-Time Compliance Monitoring:
- AI-powered systems stay updated with the latest regulatory changes and ensure that the laboratory billing process (RCM cycle) adheres to current laws and guidelines. This minimizes legal risks and ensures compliance without manual oversight.
Improved Patient Experiences:
- AI chatbots and automated systems can handle patient inquiries regarding lab billing, provide estimates, and set up payment plans. This improves patient satisfaction and encourages timely payments.
Avunjian also pointed out a less obvious benefit of AI integration: its potential to address workforce shortages by streamlining processes and reducing manual workloads. His insights underlined AI’s role in advancing efficiency and driving sustainable growth in laboratory operations.
He believes AI and ML solutions will become integral laboratory billing components because the interpretation of large and complex data sets and continuous learning capabilities of AI and ML algorithms means these systems will only become more accurate and efficient over time and clinical laboratories and pathology practices that adopt these technologies early will gain a competitive advantage through cost savings and improved operational efficiency.
Learn More: How Billing and Coding Automation Increases Laboratory Revenue
LIS System and Laboratory Billing Integration Key to Stopping Revenue Leakage
Avunjian next highlighted the critical importance of addressing lab billing inefficiencies in today’s era of shrinking margins and rising operational costs by emphasizing laboratory information system (LIS) and lab revenue cycle management (lab RCM) integration as key to overcoming these challenges.
By positioning LIS system software and lab RCM integration as a cornerstone of modern laboratory operations, Avunjian underscored its positive impact on business and compliance.
Avunjian further highlighted the other ancillary benefits of LIS software and laboratory billing system integration, including reduced IT maintenance costs, fewer licensing needs, and increased automation.
End-to-End Data Integrity:
- An all-in-one integrated medical LIS and lab RCM platform ensures consistent and accurate data flow from start to finish by maintaining a single source of truth for orders, results, and lab billing information. This eliminates redundant data entry and discrepancies between two disparate systems that result in denials and delayed payments.
Faster Lab RCM Cycle:
- Medical LIS and lab RCM integration allows quicker lab billing and faster reimbursement cycles by linking technical and financial operations while embedding real-time access to third-party services that specialize in patient demographic verification, insurance eligibility, insurance discovery, claim submission, and claim status into a single source of truth platform.
Simplified Compliance:
- An all-in-one medical LIS and lab RCM platform simplifies compliance with regulations like HIPAA and CLIA by ensuring all transactions are traceable and secure while also providing comprehensive analytics and operational insights that the lab can use to eliminate bottlenecks and improve processes.
Reduced IT Costs:
- Integrated LIS systems with laboratory billing solutions reduce IT maintenance costs by eliminating the need for multiple software licenses and support teams. An integrated platform such as this optimizes resource utilization, reduces administrative overhead, and maximizes automation.
Adaptability:
- An integrated medical LIS and lab RCM platform is also much more adaptable to changes in laboratory billing codes, regulatory requirements, demographic changes, and lab services, all of which better support lab growth and scalability when compared against multi-system solutions.
Avunjian believes labs can truly help themselves with improved efficiency, accuracy, compliance, and financial performance by integrating LIS systems and laboratory billing solutions into one source of truth backed by automation,
Learn More: Maximizing Your Lab’s Profitability: The Case for In-House Lab Billing
The Costs Associated with Non-Integrated Laboratory Billing Systems
In addition to the CLP article, here’s one more way you and your lab colleagues can learn what a difference one source of truth can make for your lab’s operational and financial workflows.
On-Demand Webinar: Unifying Technical and Financial Operations to Minimize Denials and Prevent Revenue Leakage