How Cole Diagnostics Streamlined Client Billing with LigoLab’s LIS & RCM Platform
November 20, 2023
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.
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.
Cole Diagnostics Overcomes RCM Adversity with Innovation
Founded in 2004, Cole Diagnostics serves as 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 fast-growing 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 billing process using LigoLab’s LIS & RCM Laboratory Operating Platform, the lab has been able to significantly reduce manual processes, receive payments faster, and increase staff efficiency.
“Because of the automation, invoices are getting out to clients in a timely, more regular fashion,” said Kelli Cole, Vice President at Cole Diagnostics. “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 platform’s impact on the lab’s staffing needs, Cole said, “at our current volume, the automation has enabled us to reduce our billing department by one less full-time employee. This will save the lab nearly $60,000 a year on salary and benefits. As our volume goes up, the lab’s efficiencies and operating costs will only improve.”
Automating the Client Billing Process
With these results in mind, labs relying on manual processes to drive their client billing operations are doing their clients and businesses a huge disservice. Not only are they leaving money on the table due to leakage and wasted time and resources, but they are also subjecting themselves to potential compliance issues.
“Laboratory client 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 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.
“We went from this very manual process of sorting through stacks of papers to being able to rely on our laboratory information system (LIS) to handle all of that work automatically,” said Cole. “Twenty percent of our lab’s business falls into the client category, so this automation really simplified things. Having one place where we can easily sort client bills from insurance bills and patient bills, and then process them in a fast, compliant manner has been an amazing improvement.”
Client Billing and its Complexities Require a Powerful RCM Solution
Faster sorting enabled the lab to handle the testing volume resulting from COVID-19 surges more easily without overhiring or reshaping the billing department. The lab also experienced reduced time spent on client accounts in accounts receivable thanks to the accuracy of the data received by the billing team. This sped up the review process, allowing for faster client invoice distribution.
“LigoLab’s automation has streamlined the workflow for us and made it easier for the billing team to work its way through it,” said Cole. “It is definitely more efficient in terms of review and having those bills go out automatically.”
In addition to the ability to automatically sort by payer, LigoLab’s rule-based platform also takes into account and supports other complexities associated with client billing. For example, some clients want things like volume discounts and other credits on a daily, weekly, or monthly rolling basis. Additionally, some clients want labs to adjust 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 billing process for a specific client, LigoLab’s revenue cycle management (RCM) module can be configured to efficiently manage it.
Compliance is Key
Another important way that automated client 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 companies do business. These laws can also significantly impact how physicians can 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 billing practices without 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 billing compliance is to replace manual workflows with automation.”
Avunjian added that the billing workflow made possible by LigoLab’s all-in-one platform is well worth the investment, citing labor and time savings, plus ongoing incremental revenue gains.
LigoLab Makes Good Business Sense
In addition to increased efficiency, lower operating costs, fewer errors, and better compliance, automated client billing also offers advantages in business development.
“Having LigoLab in place right before COVID gave us the ability to pivot and provide testing for a lot of hospitals and health systems in our region,” said Cole.
Cole said the lab explored other options to improve client billing before identifying LigoLab’s 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 system and credited LigoLab’s dedicated RCM support team for being very responsive and helpful, providing regular check-ins.
“They're very attentive and very 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 system presents and the ability to customize exactly what works for each one of our customers.”
The LigoLab LIS & RCM Laboratory Operating Platform
For lab managers looking for the same advantages as Cole Diagnostics, LigoLab offers the perfect automated client billing solution as part of a comprehensive platform that efficiently covers all RCM workflows (client, payer, and patient billing).
The LigoLab LIS & RCM Laboratory Operating Platform is a comprehensive and flexible SaaS solution that features two fully integrated modules, a laboratory information system and a revenue cycle management module, with both 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 systems. Most importantly, it enables the 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. All of this upstream support and integration has consistently resulted in significant improvement in net collections for platform users.
The Platform also features the Billing Encounter, the driving force that consolidates all relevant 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 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 platform can transform clinical and pathology laboratories into information-driven, connected, and thriving businesses, visit LigoLab.com.