Case Study
Leveraging LIS System & Lab RCM Integration to Improve the Laboratory Billing Process
September 4, 2026
Analysis
Most clinical laboratories and pathology groups rely on legacy and standalone laboratory information system (LIS) software for operations and testing, and laboratory revenue cycle management (RCM) platforms for reimbursement. However, high denial rates and sizable write-offs have long been part of this siloed laboratory billing process.
Today, market pressure and tightening margins are compelling medical laboratories to reevaluate how their LIS systems and laboratory billing solutions operate to remain resilient through increasingly challenging conditions.
What You Will Learn
In this white paper, we examine how most medical laboratories continue to manage laboratory billing today, and the inherent risks and limitations of this traditional approach.
We also present an alternative perspective and a modern collection model that unifies lab information and laboratory billing workflows, helping diagnostic testing facilities protect their operations against mounting external pressures.
Discover More: Reduce Denials and Stop Revenue Leakage With Integrated Laboratory Billing Management
A New Laboratory Billing Perspective
Historically, these businesses began the laboratory billing process only after finalizing and distributing the lab report. This post-analytical approach was deemed acceptable when margins were stronger, financial pressures were lower, and laboratories could remain profitable despite the limitations of standalone billing workflows.
That environment no longer exists. Today, lab directors and managers are under intense pressure from staffing shortages, reimbursement cuts, payer-specific requirements, rapidly evolving rules, increased regulatory oversight, and a growing share of patient financial responsibility.
As a result, laboratory leaders are increasingly open to change and actively seeking more effective, integrated approaches to managing the lab RCM cycle.
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We’ll highlight the advantages of initiating the laboratory billing process as soon as an order enters the lab, supported by powerful revenue cycle management tools that help protect revenue from the start.
We will also discuss how leveraging automation and an end-to-end medical laboratory information system & laboratory billing informatics platform enables these businesses to gain maximum efficiency, real-time patient and insurance data verification, clean claim validation, and operational insights, all while increasing net collections and improving patient, client, and payer satisfaction.
There is a much-needed paradigm shift taking place within the industry as the accepted, old, and disconnected laboratory billing process is being replaced with a new way of thinking and new powerful laboratory billing solutions that help organizations meet their present and future challenges, become more profitable, gain an edge over the competition, and steadily grow their technical and financial operations.
Get Insight: The Power of Integration - Unleashing the Potential of LigoLab's LIS System & Lab RCM Platform
A Fully Integrated LIS System & Laboratory Billing Platform
Across the United States, an estimated 35 percent of claim denials and rejections stem from inaccurate or incomplete data. Fragmented laboratory billing systems and standalone laboratory billing solutions compound this problem by creating disconnected workflows and data silos. Without seamless synchronization and visibility across clinical and financial processes, data inconsistencies lead to more denials, delayed reimbursement, and preventable revenue loss.
Laboratories operating under this model have historically had two costly options: devote additional resources to rework and resubmit claims, or absorb the loss by writing them off as bad debt.
However, a better approach to laboratory revenue cycle management is gaining momentum. Lab leaders nationwide are moving away from outdated laboratory billing solutions and adopting flexible, all-in-one LIS software platforms with embedded lab billing functionality that leverages integration and automation to improve net collections, reduce reliance on manual labor, and support scalable growth.
Get Insight: Understanding the Real Costs of Non-Integrated RCM Systems
Avero Diagnostics Laboratory Billing Case Study
Tina Quevedo is the Senior Director of the Business Office at Avero Diagnostics, a high-volume, full-service laboratory supporting pathology and clinical testing across multiple locations nationwide.
Avero has partnered with LigoLab for its laboratory information system software since March 2015. In January 2019, the laboratory expanded the partnership by replacing its legacy laboratory billing vendor with LigoLab’s fully integrated platform, unifying its RCM with comprehensive anatomic pathology and clinical laboratory management capabilities.
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From Fragmented Laboratory Billing to a Fully Integrated Lab Workflow
Within four months of deploying LigoLab's fully integrated laboratory billing module, Avero began seeing measurable improvements in efficiency, accuracy, and net collections.
With new revenue cycle management tools and full transparency, Quevedo and her team gained real-time access to accurate demographic and lab billing data at the front end of the RCM cycle, capabilities the organization previously lacked.
Before full integration, LigoLab's LIS system software interfaced with Avero's standalone laboratory billing system from a well-known RCM vendor. But, according to Quevedo, the arrangement proved cumbersome, particularly for handling technical and professional component (TC/PC) splits. The legacy laboratory billing system lacked critical functionality and visibility.
While staff coded in LigoLab's LIS system module, they maintained billing rules separately in the legacy laboratory billing software, which often prevented them from submitting claims even when the data was accurate.
The legacy laboratory billing system also lacked real-time claim scrubbing, limiting the team's ability to validate information before submission. In addition, it generated double balances and false refunds, creating accounting discrepancies and requiring frequent manual intervention.
As a result, Quevedo said her team was forced to manually review every payment application on the backend to ensure accuracy, an inflexible and time-consuming process. She also expressed frustration with the limited support and responsiveness provided by the outsourced vendor when issues arose.
On-Demand Webinar: Unifying Technical and Financial Operations to Minimize Denials and Prevent Revenue Leakage
Integrated LIS–RCM Workflows Shift Focus From Data Cleanup to Revenue Recovery
Quevedo noted that her team now can focus on higher-value activities such as appeals management and payment collection, rather than spending time tracking down missing or inaccurate patient demographic and insurance information.
As soon as a lab order is created, Avero's system automatically performs demographic lookup, address validation, prior authorization checks, live eligibility verification, and insurance discovery.
Because LIS and RCM workflows operate within a single, shared lab database software platform, interdependent data is immediately accessible across both environments, eliminating the need to manually synchronize information for clients, tests, payers, and other critical data elements.
The platform also automatically identifies duplicate patient demographics and histories, and real-time interfaces with the Centers for Medicare & Medicaid Services and the NPI Registry make adding new provider information quick and accurate.
At the core of this modern solution is an "Encounter" data structure that consolidates patient demographics, orders, and claim data into a single, real-time view.
Supporting documents, including requisitions, reports, and test results, are immediately accessible within the same screen, streamlining laboratory workflow management and enabling a seamless transition from testing and reporting to laboratory billing and payment processing.
Get Insight: How Best Practices and Advanced Laboratory Information System Technology Help Ensure Lab Workflow Management
A Closer Look: Avero's Results
Avero experienced unprecedented revenue growth, with net collections increasing 31 percent year over year between January 2019 and January 2020, achieved without adding operating costs.
Powered by automation, flexible statement scheduling, fully customizable statement templates, and improved patient engagement, patient net collections alone rose by 30 percent.
With efficient RCM tools built into the unified LIS lab platform, Avero issued patient statements an average of three weeks sooner than before. This earlier outreach significantly accelerated cash flow.
LigoLab’s all-in-one informatics platform also enabled a more patient-centric payment experience.
Through an online payment portal with automated posting, patients could pay quickly and conveniently, supported by email and SMS reminders. As a result, 36 percent of patients chose to pay through the online portal, further improving collection performance and operational efficiency.
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Automation and Integration Drive Significant Gains in Client and Payer Collections
Avero's client net collections increased by 45 percent, driven by the automation, integration, customization, and streamlined payment management built into the platform. These capabilities significantly reduced reliance on manual processes and helped minimize clerical errors.
Another key contributor was automated client notifications, which enabled Avero's clients to review charges daily rather than waiting for a comprehensive end-of-month statement. This early visibility allowed clients to ask questions, flag discrepancies, or dispute charges in advance, resulting in fewer post-invoicing issues and faster payment cycles.
Payer net collections also rose by 27 percent. Real-time access to patient demographics, insurance discovery, and eligibility verification enabled optimized claims and a substantially higher first-pass resolution rate than the previous year, well above the national average. Automated CPT and ICD-10 coding, along with real-time rejection and denial queues, further contributed to these gains.
In addition to significant gains in net collections, Avero achieved measurable improvements across key performance indicators.
Avero's annual net collections per employee increased by 31 percent, as full-time staffing levels remained flat year over year despite significant growth in overall collections, demonstrating true revenue growth without added operating expense.
In addition, improvements drove a substantial increase in productivity, with Avero submitting 22 percent more claims (adjusted for growth) compared to the prior year.
Industry Insights: Why the Future of the Laboratory Information System Must Be Active, Intelligent, and Integrated
Conclusion
Independent pathology, clinical, and reference laboratories face mounting industry pressures that make decisive action increasingly important. By adopting a future-ready platform that unifies LIS and lab revenue cycle management capabilities, customers can strengthen operations, protect revenue, and position themselves for sustainable growth despite an increasingly challenging healthcare environment.
The platform laboratories choose to align with must be fully integrated, accessible through open architecture, comprehensive, transparent, and secure. It should deliver real-time data at the very start of the laboratory billing process, enabled by deep integration and automation. This level of alignment enables laboratories to achieve exceptionally high first-pass clean claim rates, well above the national average, while dramatically reducing the need for costly, manual claim rework.
An effective lab RCM solution should also include automated coding, secure online payment processing, and the ability to manage and monetize large volumes of data. As the platform continuously learns and adapts, it becomes increasingly efficient over time.
A modern, integrated medical LIS and laboratory revenue cycle management platform, such as the solution offered by LigoLab, positions laboratories to scale through improved net collections and operational efficiency, meeting the complex and evolving needs of laboratories of all sizes.
Get Insight: The LigoLab Difference - Demonstrating the Power of Lab RCM Automation in the Clinical Laboratory
Laboratory Billing Wish List
With a future-ready laboratory information system & laboratory billing informatics platform, organizations can enhance their RCM cycle in the following ways:
- Gain full operational and financial control through complete transparency across laboratory workflows and billing processes.
- Capture accurate lab billing data at the front end of the RCM cycle, including mailing vendors, multiple clearinghouses, the NPI Registry, and payment processors, to ensure synchronized, reliable data exchange.
- Enable bidirectional integration with key third parties, including mailing vendors, multiple clearinghouses, the NPI Registry, and payment processors, to ensure synchronized, reliable data exchange.
- Reduce manual effort and clerical errors by using automation, operational and financial insights, and advanced data tracking to streamline and simplify the LIS system and laboratory billing workflows.
- Automate CPT coding at multiple stages of the RCM cycle, ensuring compliance with PTP, MUE, NCCI, custom payer rules, and all applicable regulations.
- Apply automated ICD-10 diagnosis assignment using configurable policies and statistical analysis to improve accuracy and consistency.
- Accelerate claims and appeals processing while lowering labor costs through automated provider and facility assignment, including TC/PC splitting.
- Address financial requirements at the point of care by generating Advance Beneficiary Notices (ABNs) and securely collecting prepayments when needed.
- Maintain quality assurance and compliance across the entire RCM cycle with a comprehensive audit trail and built-in QA/QC controls.
- Leverage machine learning to analyze RCM cycle data, continuously refine workflows, and drive ongoing process improvement.
- Improve operational visibility with real-time laboratory workflow management queues (tailored to each laboratory role).
- Monitor performance with advanced analytics, including detailed reports on trends, KPIs, and benchmarks, all within a single, unified informatics platform.
White Paper: Vendor to Partner - How Aligning with Your LIS Provider Can Transform Your Lab
More Laboratory Billing Insight To Consider
After an organization recognizes the need to modernize its laboratory revenue cycle management to remain viable and profitable, the next step is to look inward and establish goals, priorities, and success metrics.
LigoLab equips forward-thinking clinical laboratories and pathology groups with the RCM tools they need to navigate today's pressures while clearly differentiating itself from traditional LIS systems and laboratory billing solutions in several key ways:
- Flexible, Configurable LIS Software - The LigoLab Informatics Platform is highly adaptable and can be configured to meet the unique operational, clinical, and financial needs of virtually any pathology or clinical laboratory.
- True Modular Growth Without Added Infrastructure - Customers can activate additional LIS, RCM, and supporting engine functionality at any time, without new servers, hardware, middleware, or interfaces, enabling seamless expansion as needs evolve.
- Enterprise-Scale Capability - The full suite of medical LIS and lab billing applications is available immediately, enabling laboratories to scale, add tests, and expand services without migrating to another system as they grow.
- Proven Implementation Support - LigoLab partners closely with laboratories throughout the implementation process, from domain analysis and validation to go-live and ongoing optimization, while actively mitigating risk. In two decades of operation, no LigoLab partner lab has rolled back after go-live.
- Continuous Innovation - The platform is continually evolving, with new features and enhancements deployed regularly to support partner laboratories and address real-world operational needs.
- Aligned, Tiered Pricing Model - Unlike legacy LIS vendors that rely on large upfront licensing fees, LigoLab invests in long-term partnerships through an aligned, tiered pricing model. This shared-risk, shared-reward LIS model enables LigoLab and its customers to grow together.
- Deep Industry Focus and Expertise - Headquartered in Los Angeles, LigoLab specializes exclusively in developing advanced LIS software for pathology, clinical, and reference laboratories.
- Expert-Driven Design and Support - By partnering with LigoLab, customers gain access to best practices and domain expertise from a platform built by pathologists and laboratorians, backed by friendly, responsive, and unlimited 24/7 customer service.
Discover More: The LigoLab Informatics Platform - Uniquely Designed to Deliver Maximum Value
Last Thought
Medical laboratories relying on outdated RCM tools and legacy laboratory billing systems are increasingly falling behind. Without a unified foundation, traditional laboratory billing processes lack the integration, visibility, and automation required to keep pace with today's operational and financial demands.
Labs that adopt a modern, all-in-one laboratory information system software platform with embedded lab billing functionality, such as the LigoLab Informatics Platform, gain the flexibility and transparency required to operate more efficiently and competitively. The result is measurable business impact, including:
- Accelerated cash flow
- Increased revenue and stronger margins
- A sustainable competitive advantage
Since 2006, LigoLab has delivered flexible, enterprise-grade laboratory information system software that powers hundreds of laboratories nationwide, driving performance, efficiency, and scalable growth.
Industry Insights: Best LIS Systems - Top Laboratory Information Systems Compared for Clinical, Pathology, and Outreach Labs
Ready to See What a Fully Integrated Medical LIS and Lab RCM Platform Can Do for Your Laboratory?
Schedule a personalized LigoLab demonstration and discover how a unified informatics platform can transform your lab's financial, administrative, and technical operations.
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Frequently Asked Questions About LIS System and Lab Revenue Cycle Management Integration
What percentage of claim denials are tied to inaccurate or incomplete data?
An estimated 35 percent of claim denials and rejections across the U.S. are linked to inaccurate or incomplete data, a challenge that fragmented, non-integrated medical LIS and laboratory billing systems can further compound.
How much did Avero Diagnostics' net collections grow after integrating its LIS and RCM workflows?
Avero saw net collections increase by 31 percent year over year between January 2019 and January 2020, without additional operating costs, after transitioning to LigoLab's fully integrated platform.
What specific collection gains did Avero see across patients, clients, and payers?
Patient net collections rose 30 percent, client net collections rose 45 percent, and payer net collections rose 27 percent, driven by automation, real-time data verification, and streamlined payment management.
What problems did Avero's legacy, non-integrated billing system cause?
The legacy system struggled with technical and professional component (TC/PC) splits, lacked real-time claim scrubbing, generated double balances and false refunds, and required manual review of every payment application, creating a significant administrative burden.
What is the "Encounter" data structure mentioned in this case study?
The Encounter is a core data structure that consolidates patient demographics, orders, and claims into a single, real-time view, with supporting documents, such as requisitions and reports, immediately accessible on the same screen.
How did online payment options affect Avero's collections?
Through an online payment portal with automated posting and email/SMS reminders, 36 percent of Avero's patients chose to pay online, improving collection performance and operational efficiency.
What should labs look for in a future-ready LIS and RCM platform?
Labs should look for full integration, open architecture, front-end data capture (eligibility, demographics, prior authorization), automated coding, bidirectional third-party integrations, machine learning-driven process improvement, and real-time analytics, all within a single unified system.
