Is Your Clinical Laboratory Ready for Direct Primary Care?

An interesting article published at Darkdaily.com has put the spotlight on Direct Primary Care as a new and emerging healthcare model in the United States that independent clinical laboratories need to be prepared for. 

For those who may not yet be aware, Direct Primary Care (DPC) is a healthcare model where patients pay a flat fee directly to primary care providers for unlimited visits and on-demand access, bypassing the traditional insurance healthcare plan. This fee typically covers all or most primary care services, including clinical and laboratory services.

Here’s a link to the Dark Daily Article: Direct Primary Care is Emerging as a New Healthcare Model in the US, But Are Clinical Laboratories Prepared to Bill Patients Directly?

Turning a Potential Problem into a Growth Opportunity

The new DPC model has gained momentum because of its potential to lower healthcare costs overall while freeing up physicians to spend much less time on insurance paperwork and administrative costs and much more time with their patients. The new model is also attractive to patients who want a healthcare arrangement that’s more cost-effective, convenient, and easy to understand.

The DPC model puts the financial responsibility for services received on the patient rather than on the payer, a subtle and manageable shift for those in the clinical lab industry with modern laboratory information system (LIS system) and laboratory revenue cycle management (lab RCM, billing) software technology, and a potential problem for those who continue to use outdated and rigid software solutions for LIS system and lab RCM activities. 

Rather than having the potential problem come to them without a viable solution in place, now is the time for clinical labs operating with legacy LIS software and laboratory billing applications to proactively protect their business interests and prepare for what seems inevitable.

Learn More: Clinical Laboratory Management Solutions for Lab Revenue Cycle Management

This requires a shift in mentality where the growth of DPC is no longer viewed as a potential problem but as an opportunity for anatomic pathology groups and clinical laboratories to modernize their operations, cater to new clients, and grow their businesses. 

Modern and Flexible LIS System and Lab Billing Software Caters to the DPC Model

For those lab leaders who realize their operations are at a disadvantage when it comes to the DPC model and other modern clinical lab workflow support, now is the time to explore what other LIS software and lab billing options are available. If it’s been a while (years!) since lab leadership last explored a software upgrade, they’ll likely be pleasantly surprised with the technology now available. 

For example, modern LIS systems and lab revenue cycle management software can easily accommodate both the traditional billing workflow with payers and the new DPC model with patients being billed directly. 

Learn More: Comparing LigoLab Informatics Platform with Legacy Laboratory Information System Software

Seamlessly Built Laboratory Information System Software Designed to Support Payers and Patients

The LigoLab LIS & RCM Laboratory Informatics Platform is uniquely configured with embedded modules to handle both the traditional fee-for-service model for payers and the emerging DPC model for patients. With LigoLab, all LIS system & lab RCM functions share one common database and software infrastructure, meaning there is no need for an interface between the two modules and no need for synchronization, resulting in the end-to-end data integrity that leads to clean claims and more profitability. The platform leverages this high-level integration plus automation to streamline lab billing workflow that starts at order origination and then advances throughout the entire laboratory testing and laboratory billing process. The end result is an increase in revenue and margins for the laboratory and greater satisfaction for the patient and the payer.

Learn More: Why Integrated LIS System and Lab RCM Software is a Catalyst for Growth

LigoLab’s all-in-one LIS system software & lab RCM captures valuable and accurate information needed for clean claims on the front-end of the lab billing cycle and fully integrates laboratory billing throughout a lab’s workflow. This gives medical labs full control and visibility of their technical and financial operations.

For payers, the LigoLab platform automates eligibility checks, insurance discovery, address validation, prior-authorization, and CPT and ICD-10 coding. All of these lab billing processes are completed in real-time and on the front-end to guard against missing and inaccurate information, the leading causes for denials.  By utilizing these Lab RCM processes and more, the platform enhances the lab’s relationship with payers, leveraging this newfound efficiency to drastically improve KPI like clean claim percentage and first-pass resolution rate while also minimizing the need for human intervention. 

White Paper: The Connected Laboratory: Leveraging LIS & RCM to Grow Your Business

For patients, the LigoLab platform harnesses automation to flexibly schedule and distribute statements at any time, and the statement templates are fully customizable. The all-in-one platform also features enhanced patient payment functionality, allowing patients to quickly receive and review their statements much faster than before and pay their bills via an online portal that automatically posts payments. Labs can also engage patients throughout the RCM cycle with both email and SMS notifications and set up payment plans. All of these functions cater to today’s healthcare consumers while also providing labs with the tools to adapt to the changing times.

Learn More: LigoLab Gives Labs a Convenient and User-Friendly Way to Incentivize Patients and Accelerate Payments

Not all labs are set-up to bill patients directly, but as the Dark Daily article states those that have or acquire this ability to directly engage patients will gain an edge in what’s become a very competitive environment. 

New to LigoLab and Curious About Combined LIS System and Laboratory Billing Solutions?

At LigoLab, we’ve provided flexible all-in-one pathology software solutions for medical laboratories since 2006, and our all-in-one medical LIS & lab billing platform is currently driving efficiency, performance, and growth in nearly 300 facilities nationwide. 

Ready to learn how a modern, all-in-one LIS software solution can revolutionize your lab’s technical and financial processes? Then you’re invited to read the following documentation to get a firsthand understanding of the power of the system from those who use it every day to sign out cases faster and be more productive and profitable.

Case Study #1: Documenting the Avero Diagnostics Move From a Legacy Lab RCM System to LigoLab’s All-in-One Lab Informatics Platform

Case Study #2: How ECPC is Leveraging LigoLab’s LIS System to Streamline Pathology Lab Workflow and Expand Laboratory Operations