Revenue Cycle Management (RCM) Solutions for Laboratories

Laboratory revenue cycle management (lab RCM) solutions are specialized lab billing software designed to streamline and unify the administrative and clinical processes involved in claims and payments. The primary goal of effective laboratory billing system software is to boost profitability by driving the following key actions:

• Cost Reductions - From automating much of the laboratory billing process and avoiding errors that lead to rework.
• Revenue Growth - From minimizing denials with more accurate and compliant claim submissions.
• Cash increases - More cash available to the laboratory and a decrease in working capital needs by cutting the time in accounts receivable.

Learn More: Five Steps to More Profitable and Efficient Laboratory Operations

If you’re interested in learning what lab revenue cycle management software specifically designed for diagnostic testing can do for your medical lab’s net collections, we invite you to schedule an introductory call with a lab RCM expert to learn more.

Act Now: Request a Call with a Lab Billing Expert‍

What Laboratory Billing Solutions are Available? ‍

Effectively leveraging billing software for labs is essential for the success of medical laboratories, as failure to adapt to evolving industry demands can leave these organizations exposed and at risk.

One way to adapt and improve as an organization is to embrace lab billing automation over manual labor.

For example, the nonprofit Council for Affordable Quality Healthcare says the healthcare industry saved $122 billion in 2020 administrative expenses through digitalization and automation.

The message on the wall is clear. Full-time equivalents (FTE) are expensive, and modern laboratory billing solutions powered by automation are the answer. 

Clinical laboratories and pathology groups have a choice. They can choose lab revenue cycle management software fully integrated into a modern laboratory information system (LIS software), or they can use a standalone laboratory billing system that interfaces with a lab information system.

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

Lab RCM and the Laboratory Billing Process

While laboratory revenue cycle management is most associated with effective claim submission and payment collection, the best billing software for labs must excel at all seven of the following RCM process stages:

• Collection: Collection of patient demographics and payer information at test order creation.‍
• Verification: Verification of patient demographics and insurance information before testing. The best lab RCM cycle platforms have direct interfaces with third-party services for patient demographics verification, insurance eligibility, and insurance discovery.‍
• Coding: Coding for diagnoses and procedures. The best lab billing software fully automates the coding process rather than relying on manual coding from a standard list.‍
• Claim Submission: The step in the laboratory billing process where coded claims are submitted to payers—such as insurance providers, clients, or patients—for reimbursement.
• Payment Collection: Payment from insurance payers, patients, and clients for the balance owed. ‍
• Denial Management: This is engaged if payment is not received and the claim requires correction, resubmission, or an appeal.
• Analysis and Reporting: Empowers lab owners and executives to leverage RCM cycle data to reduce costs, increase profitability, and enhance patient outcomes.

Learn More: How Billing and Coding Automation Increases Laboratory Revenue

Laboratory Revenue Cycle Management Software Trends

Global Market Insights projects that the healthcare lab RCM market will grow at a rate of over 12% annually, from just over $52 billion in 2019 to nearly $115 billion by 2025.

This growth is fueled by increasing demand from medical laboratories and other sectors within the healthcare system. According to CAQH, the same group that estimated that automation and digitalization helped care companies avoid $122 billion in costs in 2020, fully automating just nine commonly performed transactions could yield a further $16 billion in savings.

Another factor contributing to the importance of revenue cycle management software is the trend (especially in the United States) toward a value-based care model instead of fee-for-service. As patients, insurance companies, employers, and other stakeholders expect more data, presented to them in timely and standardized ways, lab billing teams must be able to rely on their lab RCM systems and/or RCM management company personnel to keep up.

Case Study: In-House vs. Outsourced Laboratory Billing – Navigating the Best Path Forward for Your Lab

Best Lab Revenue Cycle Management Companies

The best lab revenue cycle management software companies have invested in the seven key RCM process stages listed above. Their laboratory billing systems are customizable, user-friendly, reliable, and packaged with high-quality technical support.

Learn More: Is Your RCM Software Vendor Putting Your Lab’s Needs First?

Conclusion

Diagnostic testing organizations need advanced billing software for labs to succeed. This need will only grow as efficient and standardized laboratory billing becomes the norm and healthcare systems move from fee-for-service to a care-based model.

Learn More: Reduce Denials and Stop Revenue Leakage With Integrated Laboratory Billing Management

LigoLab’s Advanced Billing Software for Labs

LigoLab is a leading provider of innovative end-to-end pathology and clinical laboratory management software solutions, supporting hundreds of facilities nationwide. 

As a comprehensive enterprise-grade LIS system and lab billing solution, the LigoLab Medical LIS & Lab RCM Informatics Platform is an all-in-one integrated platform that supports every role, department, and case, enabling laboratories to deliver better patient outcomes as they differentiate in the marketplace, scale operations, become more compliant, and more profitable.

Learn More: Best Pathology Lab Reporting Software - 2025 Buyers Guide and Checklist

LigoLab's RCM module is fully integrated with its advanced LIS software platform, streamlining financial operations by automating ICD/CPT coding and other critical billing tasks. This automation helps reduce audit risk and boost profit margins.

The laboratory billing process begins at order creation, incorporating real-time RCM tools for verification, eligibility checks, and claim scrubbing to maximize clean claim rates, increase revenue, and minimize denials and compliance risks.

Committed to true partnership, LigoLab takes full ownership of its clients’ information system needs, allowing laboratories to stay focused on delivering accurate diagnostics that support informed clinical decisions for providers and patients.

Learn More: Navigating the Future of Pathology: The LigoLab Advantage

 For more information or to request a tailored demonstration of LigoLab’s LIS software or laboratory billing solutions, contact a product expert. 

Act Now: Speak with a LigoLab Product Specialist‍