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Six Reasons Why You Should Choose an Integrated Laboratory Billing Solution for Your Medical Lab
November 19, 2024
Your clinical laboratory or anatomic pathology lab did the work, and now you want to get paid for services rendered.
Seems straightforward, right?
Wrong!
Spend a minute in a medical laboratory billing department and you quickly learn that successful laboratory revenue cycle management (lab RCM) is more often than not impeded by a complex mix of barriers such as:
Payer Complexity: Insurance companies are a major challenge for lab billing because they present different policies, coverages, and requirements. This lack of uniformity requires either additional labor costs or the acquisition of a robust laboratory billing system to navigate the various companies and their specific requirements.
Coding Errors and Documentation: Only with proper ICD-10 and CPT coding and precise documentation of tests, test results, and patient information can a medical lab be assured of accurate payment for the tests conducted. Errors from improper coding and documentation result in delays, and even worse, denials.
Learn More: How Lab Billing and Coding Automation Increases Laboratory Revenue
Regulatory Compliance: As part of the lab RCM process, medical laboratories must adhere to strict regulations set forth by government agencies. Failure to do so puts the lab at risk of penalties or audits.
Laboratory Software Systems and Technology: Billing software for labs must be compatible with laboratory information system software (LIS software; LIS meaning medical). It also must be regularly updated and compatible with current coding standards and payer and regulatory requirements. Outdated laboratory billing solutions are prone to errors that make successful lab revenue cycle management much more difficult.
It only takes a minor mistake to derail a laboratory billing process and put a payment in doubt. Because of this, more and more lab operators are turning away from the traditional way of conducting laboratory billing and embracing the advantages of integrated laboratory billing solutions.
Learn More: Understanding the Real Costs of Non-Integrated Laboratory Billing Systems
Integrated Laboratory Billing Solutions, Explained
So what is integrated laboratory billing and why is it such a welcome departure from the laboratory billing process of the past?
Integrated lab billing is achieved when modules for a laboratory information system (LIS system) and laboratory billing system are united within one unified laboratory software system database and infrastructure.
Unlike non-integrated laboratory billing systems that are interfaced with disparate laboratory information systems (medical LIS) and require more labor, have limited scalability, and are subject to data silos and compliance issues, integrated lab information system and lab RCM system software creates end-to-end data integrity and efficient and reliable lab billing workflow that starts as the test order comes into the lab.
Aided by real-time demographics verification, eligibility, and scrubbing actions that fire at this initial stage and automation and transparency throughout the lab RCM cycle, the clean claims ratio greatly increases, compliance liability decreases, and revenue leakage is stopped cold.
Learn More: The LigoLab Difference: Demonstrating the Power of RCM Automation in the Medical Lab
LigoLab’s Integrated Lab RCM Solution vs. Non-Integrated Laboratory Billing Solutions
LigoLab realized long ago that the best billing software for labs needs to be intimately tied to a robust LIS laboratory information system platform, for this is the only way to remove common laboratory billing problems and truly gain overall lab efficiency and profitability.
LigoLab Informatics Platform accomplishes this by managing and consolidating interdependent LIS system and lab billing data into a single easily accessible data entity, known as the Billing Encounter.
Consolidated within the Billing Encounter are order and specimen information, patient and payer demographics, ICD-10 and CPT coding, lab billing details, remittance, and processing data.
The Billing Encounter is the driving force behind the logic that simultaneously supports LIS medical and lab RCM module processes throughout the entire lifecycle of a case.
Learn More: Maximizing Your Lab’s Profitability: The Case for In-House Lab Billing
A Deeper Dive into the Advantages of Integrated Laboratory Billing
Now let’s look at the differences between the integrated laboratory billing solution offered by LigoLab and non-integrated lab revenue cycle management software.
Customization
- An integrated laboratory billing solution has unlimited operational configuration and customization options, making it adaptable to all aspects of clinical laboratory workflow.
- Non-integrated laboratory billing solutions have limited functionality and configuration options.
Data Integrity
- An integrated laboratory billing solution removes common lab RCM problems like data silos and constant synchronization with a unified laboratory billing process that produces significant revenue growth.
- A combination of rigid modules and separate laboratory software systems for LIS and RCM functions requires constant synchronization with non-integrated laboratory billing solutions, and data integrity is questionable as the data moves from one system to the next.
Validation
- An integrated laboratory billing solution with embedded data validation RCM tools backed by powerful third-party lab vendors results in a much higher First-Pass Resolution Rate (FPRR) than the industry benchmark of 85 and 95 percent.
- Non-integrated laboratory billing solutions are labor-intensive, have error-prone data validation processes, and limited visibility for laboratory workflow and data processing.
Workflow
- An integrated lab RCM solution has synchronized workflow queues supporting accountability, transparency, and workflow efficiency.
- Non-integrated laboratory billing solutions have questionable workflow options that increase the chance of errors due to compartmentalization across two laboratory software systems.
Automation
- An integrated laboratory billing solution with automation enables the elimination of manual and repetitive tasks and promotes scalability and maintainable fiscal growth.
- Non-integrated lab RCM solutions have higher risks associated with scaling, unanticipated industry changes, and longer vicious business cycles.
KPIs
- An integrated laboratory billing solution supports robust and customizable executive-level report generation, dashboards, and real-time KPI metric analytics.
- Non-integrated laboratory billing solutions offer users only basic metrics analytics and static reporting capabilities.
Learn More: The Power of Integration: Unleashing the Potential of LigoLab's LIS System & Lab RCM Platform
Consider Partnering with LigoLab for Your Lab RCM
Going beyond the direct comparison between integrated and non-integrated laboratory billing solutions, here’s a bit more to consider:
- Medical labs that partner with LigoLab for their laboratory billing solutions consistently report ongoing revenue gains of 15-35 percent within three months of implementation.
- With LigoLab, getting paid on the first pass at a rate of 95 percent or higher is not only achievable, it’s a routine benchmark for our partner labs.
- Thanks to an informatics platform that automates tasks to streamline and simplify lab workflow whenever possible, our partner labs consistently report manual labor reductions upwards of 30 percent.
At LigoLab, we’ve provided flexible all-in-one LIS systems with powerful laboratory billing solutions for growing clinical laboratories and pathology groups since 2006, giving them what they need to modernize and grow efficiently.
To learn more about our LIS software and laboratory billing solutions and how they can modernize your lab’s administrative, technical, and financial operations, contact us to schedule an interactive demonstration. That way you can see for yourself how our fully integrated informatics platform unites and transforms every aspect of lab workflow.
