How Cole Diagnostics Streamlined Client Billing with LigoLab’s LIS & RCM Platform

There is no doubt that laboratory diagnostics play an invaluable role in the clinical care of patients. Considered by many to be the workhorse of healthcare, nearly 70 percent of today’s medical decisions are dependent on medical laboratories and the tests they perform. 

But despite their importance, these are challenging times for labs. Many are grappling with exploding costs, shrinking margins, unprecedented staffing shortages, and an ever-tightening regulatory environment.

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Under the pressure of these problems, some labs are teetering on the brink of collapse as they urgently search for new ways to succeed. But all is not lost, thankfully. There is hope as labs find innovative new ways to keep the lifeblood of their organizations flowing. 

One such lab is Idaho-based Cole Diagnostics. 

Overcoming Lab RCM Adversity with Innovation 

Founded in 2004, Cole Diagnostics is a comprehensive, full reference laboratory specializing in pathology, cytology, molecular, microbiology, clinical chemistries, immunoassay, tissue staining, and more. 

Led by Dr. Ryan Cole (Chief Medical Officer and Laboratory Director), the medical lab has invested in the latest and most effective technology, ensuring that cutting-edge science is at play to get the most accurate answers possible, thereby improving patient outcomes.

Although others in the industry struggle, one can make the case that Cole Diagnostics is not only surviving, it’s thriving. 

One thing that has helped Cole Diagnostics overcome many of the industry’s woes is technology. 

By simply automating its client laboratory billing process using LigoLab’s LIS & RCM Laboratory Informatics Platform for lab revenue cycle management (lab RCM), the lab has significantly reduced manual processes, receives payments faster, and has enjoyed increased staff efficiency.   

“Because of the automation, invoices are getting out to clients in a timely, more regular fashion,” said Kelli Cole, the lab’s Vice President. “As a result, clients pay us on a better timeline. For example, it accelerated the payments of one of our major client accounts by a month.”

When asked about the LIS system and lab RCM platform’s impact on the lab’s staffing needs, Cole said, “At our current volume, the automation has enabled us to reduce our lab billing department by one less full-time employee. This saves the lab nearly $60,000 a year on salary and benefits. As our lab’s volume goes up the lab’s efficiencies and operating costs will only improve.” 

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Automating the Client Laboratory Billing Process 

With these results in mind, clinical labs and pathology practices relying on manual processes to drive their client lab billing operations are doing their clients and businesses a huge disservice. Not only are they leaving money on the table due to revenue leakage and wasted time and resources, but they are also subjecting themselves to potential compliance issues. 

“Client laboratory billing has traditionally included time-consuming, mostly manual processes that often led to mistakes and delays in payment for services rendered,” said LigoLab CEO Suren Avunjian. “Until recently, the only way to address this problem area was to expand the in-house laboratory billing department and hire more full-time employees. This, however, was not an effective long-term solution.”

With labs being pushed to their limits already, forward-thinking lab executives like Cole understand the value that comes from the steady movement toward digitization.

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“We went from a manual laboratory billing process of sorting through stacks of papers to being able to rely on our laboratory information system (LIS system) to handle all of that work automatically,” said Cole. “Twenty percent of our lab’s business falls into the client lab billing category, so this automation really simplified things. We now have one place where we can easily sort the client from insurance and patient bills, and then process them fast and compliantly. This has been an amazing improvement.” 

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Client Lab Billing and its Complexities Require Powerful Laboratory Billing Solutions

Faster sorting enabled the lab to handle the testing volume resulting from COVID-19 surges more easily without overhiring or reshaping the lab billing department. The lab also experienced reduced time spent on client accounts in A/R thanks to the accuracy of the data received by the laboratory billing team. This sped up the review process, allowing for faster client invoice distribution.

“LigoLab’s automation has streamlined clinical laboratory management for us and made it easier for the lab billing team to work its way through the RCM cycle,” said Cole. “Our reviews are definitely more efficient with those bills going out automatically.”

In addition to the ability to automatically sort by payer, LigoLab’s rule-based and automated platform supports other complexities associated with client lab billing. For example, some clients want volume discounts and other credits on a daily, weekly, or monthly rolling basis. Additionally, some clients request adjustments for their patients with alternate payment methods. As such, not only do labs have rolling totals and discounts to contend with, but they also have a variety of payment methods to account for. This gets even trickier when you consider the potential consequences if double-billing were to occur. 

No matter the complexity of the laboratory billing process for a specific client, LigoLab’s lab revenue cycle management (RCM) module and its powerful laboratory billing solutions can efficiently manage and support it.  

Laboratory Billing Compliance is Key

Another important way that automated client laboratory billing improves the way labs operate is when it comes to compliance with laws and other rules like the Clinical Laboratory Improvement Amendments (CLIA), the Anti-Kickback Statute (AKS), and the Eliminating Kickbacks in Recovery Act (EKRA). 

These laws are important as they can dictate how, where, and with which entities laboratory testing organizations do business. These laws can also significantly impact how physicians order critical tests for their patients.

To put it bluntly, coding complexity and stricter compliance guidelines make it very difficult for labs to maintain and enhance lab billing practices without lab RCM automation. 

“As laboratories and medical groups expand nationally, it is important for laboratories not to overlook compliance with applicable laws and regulations, including states’ direct billing, anti-mark-up, and disclosure laws,” said Avunjian. “The best way to ensure lab billing compliance is to replace manual workflows with lab RCM automation.”

Avunjian added that the laboratory billing workflow made possible by LigoLab’s all-in-one lab information system and lab revenue cycle management platform is well worth the investment, citing labor and time savings and ongoing incremental revenue gains. 

Learn More: The LigoLab Difference: Demonstrating the Power of Lab RCM Automation in the Clinical Laboratory

LigoLab’s All-in-One LIS System Software Makes Good Business Sense

In addition to increased efficiency, lower operating costs, fewer errors, and better compliance, automated client lab billing also offers advantages in business development.

“Having LigoLab in place right before COVID gave us the ability to pivot and provide testing for many hospitals and health systems in our region,” said Cole.

Cole said the lab explored other options to improve client lab billing before identifying LigoLab’s lab RCM solution as the most efficient option. She said it took about three months to get all of the lab’s clients set up and configured within the laboratory billing system. She credited LigoLab’s dedicated support lab RCM team for being very responsive and helpful, providing regular check-ins.

“They're very attentive and willing to answer questions and solve problems. They help us find better solutions every step of the way,” she said. “We appreciate the flexibility the LigoLab platform presents and the ability to customize exactly what works for each of our customers.”

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The LigoLab LIS & RCM Laboratory Informatics Platform

For lab managers looking for the same advantages as Cole Diagnostics, LigoLab offers the perfect automated client lab billing solution as part of a comprehensive informatics platform that efficiently covers all lab RCM workflows (client, payer, and patient billing). 

The LigoLab all-in-one laboratory information system and lab revenue cycle management platform is a comprehensive and flexible pathology lab software featuring two fully integrated modules sharing the same database and software infrastructure. This arrangement ensures data integrity from start to finish, eliminating the dreaded data silos and the need to synchronize between multiple laboratory software systems. 

Most importantly, it enables the lab billing process to begin at order origination with the support of up-front address and patient demographic validation, insurance eligibility check, and insurance discovery, all available in real-time. This upstream support and integration has consistently resulted in significant improvement in net collections for platform users. 

Case Study: Leveraging LIS System & Lab RCM Integration to Improve the Laboratory Billing Process

The Platform also features the Billing Encounter, the driving force that consolidates all relevant case information within a single data entity, including order and specimen, patient and payer demographics, coding, billing, and remittance processing. The Billing Encounter enables data to seamlessly flow into real-time lab workflow queues while also providing user-defined filters and templates that allow for the configuration of rules, and the strategic distribution of work, with full audit trail visibility. 

To learn more about LigoLab and how its future-ready informatics platform can transform clinical and pathology laboratories into information-driven, connected, and thriving digital businesses, visit LigoLab.com or contact a LigoLab product specialist to request a software demonstration. 

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