Case Study
Documenting the Avero Diagnostics Move From a Legacy Lab RCM System to LigoLab’s All-in-One Lab Informatics Platform
October 3, 2025
This case study outlines the challenges Avero Diagnostics faced while operating on two disconnected laboratory software systems, one managing laboratory information system (LIS) workflow and the other handling laboratory billing (lab revenue cycle management, lab RCM). It also demonstrates the measurable gains the organization has achieved since transitioning to LigoLab’s all-in-one LIS system platform with advanced laboratory billing solutions.
Avero Diagnostics, formerly known as Northwest Pathology and Northwest Laboratory, is a physician-led national laboratory with facilities in Bellingham, WA, Irving, TX, and Lubbock, TX. The lab specializes in women’s health, anatomic and clinical pathology, molecular pathology, and clinical diagnostics.
Tina Quevedo had two clear mandates to oversee and manage upon returning to Avero Diagnostics after a nearly two-year absence while working for a non-profit.
- Replace a well-known but underperforming legacy laboratory revenue cycle management (lab RCM) software with an advanced laboratory billing system that would drastically improve staff productivity and cash flow.
- Quickly retrieve and get payment for 47,000 stuck encounters in the old lab RCM system.
Fortunately, Quevedo was up for the challenge. Using both her 30 years of experience and her familiarity with countless other laboratory billing solutions, she quickly sized up the problem and recommended a clear path forward for lab leadership to approve.
Industry Insights: Tips for Laboratory Billing Reimbursement Challenges
Investigating the Problem and Determining the Correct RCM Cycle Solution
Quevedo has always thrived on puzzles and finding the root cause of problems. She enjoys the investigative process of troubleshooting, and when something goes wrong, she needs to understand why.
“What happened? Where did it start? Let’s work backward, identify the issue, and fix it,” she recalled of her mindset when she rejoined Avero in December 2022 as Senior Director of the Business Office, after two years away from the lab industry.
“Sometimes the fix is just a bandaid, and sometimes it means rethinking the entire process,” she added.
That curiosity and problem-solving ability were exactly what Avero needed to dig out from under a massive backlog of claims caused by an RCM software company that failed to deliver as promised. After a quick assessment of the lab’s billing operation, Quevedo realized the challenges went far beyond bandaid fixes.
“We literally couldn’t get claims out of the old lab billing system,” she explained. “Fields were missing, scrubbers weren’t functioning, and even when fields weren’t required, the system would sweep and flag errors anyway. We couldn’t get claims out the door, and the ones that did go out often lacked the information needed for adjudication. The volume of front-end rejections was overwhelming.”
The problems didn’t stop there. Avero’s Irving (TX) lab couldn’t verify insurance eligibility or scrub claims with the AF modifier, which flags a specialty physician. Without this modifier, the laboratory billing team had no way of knowing whether claims were being submitted to the correct payer.
Automation and transparency were also missing. Staff complained that the old system was too restrictive and couldn’t handle the lab’s growing volume. It required excessive manual steps and clicks, and there was no effective communication between departments. For example, coders had no way of knowing if the demographics team had placed a hold on a claim, leading to claims bouncing back for missing information.
In a desperate attempt to keep up, the lab added 44 people to the billing department. Still, the issues persisted.
Quevedo factored all of this into her evaluation and quickly concluded that a complete system change was the only path forward.
“It was obvious to me that we needed to move to another lab billing solution if we were going to clear the 47,000 encounters stuck in the old RCM system,” she said. Despite weeks of attempted workarounds with IT and leadership, nothing worked.
“From that experience, I knew right away,” she said.
Quevedo advised lab leadership to make an immediate switch to LigoLab’s advanced laboratory billing software. Leadership agreed, and by February the transition to LigoLab’s RCM solution was already underway.
Industry Insights: Roundtable Discussion: Laboratory Billing Solutions and the Lab RCM Process
Implementation of the New Lab Billing Solution and Early Results
Quevedo described the implementation of LigoLab’s advanced laboratory billing solution as easy and seamless. She already had familiarity with LigoLab’s diagnostic lab software and had previously worked with its lab billing support team. Additionally, Avero Diagnostics was already using LigoLab’s informatics platform for all of its LIS system workflow and data management. These factors helped pave the way for a very smooth transition.
The move was first initiated in February, and by April 2023 all but surgical claims had been moved to LigoLab’s lab RCM module. By August 2023, the move was complete.
“I don't know what was required on LigoLab’s side, but as far as I'm concerned, LigoLab flipped a switch and we in the billing department went to work,” said Quevedo. “Kenny Moreno (LigoLab’s lead RCM Product Manager) did an amazing job. He ran an automation that recreated that whole list of 47,000 encounters. Over just two days, those stuck encounters were moved from the old lab billing system and into LigoLab’s RCM module.”
From there, the billing department’s demographics team started working on the now accessible encounters, and in less than six weeks they resolved the backlog and moved all the claims from demographics to coding before submitting them to the various payers.
The 47,000 previously stuck claims resulted in payments totaling just over $4.75 million.
Quevedo further described the implementation process.
“We had a handful of meetings and worked together to update some client rules, bring over master lists into the Irving system, and build a master table. It was all very smooth,” she said.
According to Quevedo, Avero Diagnostics started to enjoy positive metrics within the first 20 to 30 days of actively using LigoLab as its all-in-one LIS system and lab billing software solution.
The data silos, sync problems, and interface issues they once struggled with were eliminated, replaced by a single unified platform where the laboratory information system and lab billing modules run on the same database and infrastructure. From the moment a test order enters the lab through the final billing step, data integrity is fully preserved.
For Quevedo, the biggest performance improvements resulted from being able to work all the denied claims and being able to attack those denied claims in bulk.
“That was a big savior for us,” she said.
She also referenced the importance of three key features embedded within the LigoLab platform.
- Real-time insurance eligibility verification
- Synchronized third-party connection with the clearinghouse
- Real-time rejection queue
“Without eligibility and that third-party connection, we were struggling,” she said. “But now when we use the eligibility function within the LigoLab platform, 95 percent of the time it comes back with accurate information that allows us to get the claims out the door, and if there’s a rejection it goes into the rejection queue and we’re notified immediately rather than having to wait for the clearinghouse to send a 277 file.”
RCM cycle metrics from November 2023 to January 2024 show how front-end improvements boosted lab billing performance and reduced the volume of rejections needing follow-up.
- 4-to-8 hours: The time it takes for the lab billing department to complete demographics and coding, submit a claim, and receive same day claim acknowledgment.
- 98.1 percent: The percentage of claims that were processed and paid on the first submission without a rework or resubmission.
- 99 percent: The percentage of claims that were processed and paid with claim scrubbing support for the clearinghouse.
All three metrics are well above accepted national benchmarks and contribute to a more streamlined and effective laboratory billing process resulting in faster payments, less time in A/R, and improved cash flow.
On-Demand Webinar: Unifying Technical and Financial Operations to Minimize Denials and Prevent Revenue Leakage
One Source of Truth and Additional Platform Features That Improve the Laboratory Billing Process
Since switching from the legacy laboratory billing system it was using and partnering with LigoLab for its LIS system and laboratory billing operations, Avero Diagnostics has enjoyed steady improvement across the board.
When asked which features have made the greatest impact since moving to fully integrated LIS and lab RCM modules with a single source of truth, Quevedo pointed first to LigoLab’s flagging system. She explained that flagging has streamlined and simplified laboratory billing tasks like TC/PC splits across multiple facilities.
“We’re all under Avero Diagnostics, but our Irving location has separate contracts and payers from our Bellingham lab, and we often co-mix them,” she said. “With LigoLab we’re able to flag our encounters automatically, and we have the flexibility to add or change footnotes on the actual reports. That aids both our coding and rejection teams.”
Quevedo continued by highlighting the automation built into the Avero laboratory billing process. She said with LigoLab, her team is now able to set up several hospital clients with their own set of automated rules.
“They all have various requirements in terms of split bills and payers, so the automation within the LigoLab platform helps us automatically map out all the different scenarios,” she said.
With the rules established, automation takes over, eliminating the need for the lab billing team to manually handle every case. This shift has made the department noticeably more efficient and productive.
Quevedo emphasized the value of her department working within a single system for both LIS and lab RCM workflows. Beyond ensuring end-to-end data integrity, this integration enables her team to immediately confirm where a service was performed, verify that the correct rendering provider is on the claim, and access all supporting documentation and attachments tied to a specimen or case.
‘Every day, every department is moving between LigoLab’s RCM and LIS modules to either fix claims or get them out the door,’ she said. ‘Having both on the same database is a huge advantage.’
She also noted a key difference from the legacy laboratory billing system LigoLab replaced: her team no longer needs to manage client billing separately from other RCM processes. All billing information is centralized, linked to the patient account, and always accessible.
‘There simply aren’t many RCM systems that provide direct client invoicing and daily notifications within the same platform,’ she added.”
White Paper: Maximizing Your Lab’s Profitability: The Case for In-House Lab Billing
System Usability and Software Support
According to Quevedo, another way LigoLab sets itself apart from the competition is with system usability.
“You can’t ask for a more user-friendly system than LigoLab,” she said. “I’ve been at this for 30 years and I’ve probably encountered 20 to 25 other lab revenue cycle management systems. There’s just no comparison. LigoLab is intuitive. It just makes sense.”
To further illustrate this point, Quevedo spoke of a recent new hire. She said the new hire was quickly trained on demographics and within two days she was up and running, matching or surpassing the productivity of staffers with years of experience.
In terms of training and software support, Quevedo said if there’s ever a problem, it gets addressed and solved promptly.
“The customer service is impeccable. I never hear them say that it cannot be done. They either give me the solution I’m looking for or provide an alternative workaround that’s comparable. They never leave me hanging,” she said.
Discover More: The Best Laboratory Information System Companies and the Advantages They Offer to Their Laboratory Clients
Final Thoughts
In summary, the switch from a legacy and outdated laboratory revenue cycle management system to LigoLab’s all-in-one medical LIS & lab RCM solution has led to widespread measurable improvements and outcomes for Avero Diagnostics.
Unlike before, Quevedo’s team now consistently meets its daily case goals. They’re no longer bogged down by multiple sweeps, repeated claim errors, and the 24-hour delays that came with reprocessing.
“Now, everything is immediate. You let the claim go, it goes into the transmission, and within a couple of hours, you see it in the clearinghouse and know if it was accepted or not,” she said.
Even better than that, Quevedo said bringing on LigoLab’s modern lab billing solution with its fully integrated LIS and RCM modules has also helped with LIS lab operations and client relations.
“In the old system, our clients often complained about delays in getting their lab reports, with turnaround times stretching to four or even six days for hospital clients,” said Quevedo. “That problem disappeared once we moved from the legacy RCM system to LigoLab’s billing platform, and we made a lot of clients happy in the process.”
Take Control of Your Lab’s Financial Future
Avero Diagnostics turned a massive backlog and outdated laboratory billing system into a streamlined, profitable operation by switching to LigoLab’s advanced lab billing software. With automation, real-time eligibility checks, and a single source of truth, the lab improved productivity, reduced rejections, accelerated payments, and boosted client satisfaction.
Ready to eliminate laboratory billing headaches and maximize cash flow?
