News
LigoLab Offers Labs Automated and Real-Time LIS Software Solutions for Prior Authorization Requirements
September 16, 2024
LOS ANGELES, CA – LigoLab, developers of enterprise pathology lab software that helps medical laboratories scale their operations, has announced that its LIS laboratory information system (LIS system, medical LIS) and laboratory revenue cycle management (lab RCM, lab billing) platform supports automated and real-time laboratory billing solutions that vastly reduce the administrative burden laboratories face when attempting to meet payer prior authorization requirements. The laboratory billing solutions help prevent denials, speed up prior authorization approval, and close a coverage gap that could otherwise put the patient at risk.
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The LigoLab Laboratory LIS & RCM Informatics Platform is a fully integrated pathology software with the lab information system and lab revenue cycle management modules sharing a unified database and operating system. This powerful arrangement - unlike traditional two-system medical LIS and lab RCM solutions - enables consistent data to flow freely through both modules in real-time with no data silos, providing a single source of truth.
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With this degree of medical LIS and lab billing integration, clinical laboratories and pathology practices can begin the laboratory billing process at order creation. Additionally, they can leverage powerful claim scrubbing and billing automation that stimulates quicker billing and faster reimbursement cycles by linking technical and financial operations. This while the linked operations also have access to embedded interfaces with third-party services that specialize in real-time patient demographic verification, insurance eligibility, insurance discovery, claim submission, and claim status.
Learn More: Reduce Denials and Stop Revenue Leakage With Integrated Laboratory Billing Management
“Obtaining prior authorization is often difficult and labor-intensive, and it usually requires a substantial amount of supporting documentation, plus several faxes and phone calls,” said LigoLab Billing Manager Farzad Abdi. “The process also typically varies greatly from one insurer to another, which means it’s hard to standardize.”
To prevent lost laboratory revenue, mitigate audit risk, and ensure patient satisfaction, Abdi said labs should consider the benefits that come with full bidirectional synchronization of third-party services that can electronically manage prior authorization requirements and cross-check, verify, and update patient demographic and insurance information at the point of care.
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“By directly interfacing with clearinghouses, mailing companies, the NPI Registry, and payment processors, labs gain access to live payer and patient verification RCM tools that not only assist with prior authorization but also ensure all claims are scrubbed sufficiently before submission. This makes them more likely to be accepted on the first pass rather than them being denied and re-worked,” said Abdi.
Abdi also noted that Ligolab’s laboratory billing solutions include a rule-driven claim scrubbing engine that provides another layer of protection for laboratories against denials.
“With our informatics platform and its million-plus rules, laboratory operators can set up custom rules based on identified payer regulations and requirements. These rules automatically check for denial patterns so the same mistakes aren’t repeated over and over again,” he said.
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Break Through Common Laboratory Billing Problems with LigoLab’s All-in-One LIS System and Lab RCM Platform
LigoLab offers an integrated LIS laboratory Information System (LIS system) and Laboratory Revenue Cycle Management (lab RCM) platform designed to streamline laboratory billing and revenue management processes. Unlike standalone lab billing systems, LigoLab's integrated approach begins the billing process as soon as a case order arrives in the lab. This method addresses common challenges associated with traditional lab billing systems, such as reduced reimbursements, payer complexity, and regulatory compliance, while also reducing labor, improving scalability, and decreasing denials and revenue leakage.
Traditional lab billing systems often require significant manual effort, are prone to clerical errors, and suffer from limited scalability and data silos. In contrast, LigoLab’s all-in-one pathology lab software solution integrates lab LIS and lab RCM data, creating an automated, transparent, and efficient workflow. This integration ensures end-to-end data integrity and avoids the pitfalls of non-integrated LIS systems and laboratory billing solutions, such as the need for constant synchronization between separate modules and the risk of errors due to compartmentalization.
Learn More: LigoLab Informatics Platform: Uniquely Designed to Deliver Maximum Value
LigoLab’s platform offers a comprehensive, flexible, and customizable informatics solution that caters to various laboratory workflows, including anatomic pathology practices (LIS pathology), clinical laboratories (medical LIS), molecular diagnostics (molecular LIS), and direct-to-consumer lab testing (TestDirectly and TestDirectly.com). The all-in-one system includes advanced data validation tools that achieve a 98% First-Pass Clean Claim Ratio, synchronized workflow queues for improved efficiency, and robust executive-level reporting capabilities with real-time key performance indicator (KPI) analytics. Additionally, LigoLab’s rule-driven automation and partnership business model, backed by 20 years of industry experience and nearly 300 clients, further enhance its capacity to drive fiscal growth and maintain compliance with evolving industry standards.
Dennis Winsten, a healthcare systems consultant with over 30 years of experience, advocates for the adoption of integrated LIS-Lab RCM models, citing their potential to help laboratories navigate external pressures and achieve sustained business success. His views highlight the benefits of integrated systems over traditional models that may struggle with increasing payer reimbursement regulations and changing industry landscapes.
Industry Insights: Why Replace Your Laboratory Information System? Things To Consider
A case study (see below) involving Avero Diagnostics demonstrates the tangible benefits of switching from a standalone lab RCM system to LigoLab’sLIS & RCM integrated platform. After making the transition, Avero experienced significant improvements in workflow efficiency and lab revenue cycle management, showcasing the effectiveness of LigoLab's all-in-one LIS software solutions.
In summary, LigoLab’s platform represents a modern, integrated approach to lab RCM, combining advanced technology, extensive configurability, and a deep understanding of laboratory operations to deliver a powerful, scalable, and effective operational and financial solution for pathology groups and clinical laboratories looking to optimize their lab revenue cycle management processes.
To learn more about LigoLab’s all-in-one informatics platform and the advanced technology it offers its lab clients, Click HERE to start a conversation with a LigoLab product specialist.
