Six Reasons Why You Should Choose an Integrated Laboratory Billing Solution for Your Medical Lab
December 18, 2023
Spend a minute in a medical laboratory billing department and you quickly learn that successful laboratory revenue cycle management (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.
Regulatory Compliance: As part of a lab’s 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 needs to be regularly updated and compatible with current coding standards and payer and regulatory requirements. Outdated laboratory billing systems are prone to errors that make successful lab revenue cycle management much more difficult.
It only takes a minor mistake to derail a lab’s RCM 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 that come with integrated laboratory billing solutions.
Integrated Laboratory Billing Solutions: Explained
So what is integrated laboratory billing and why is it such a welcome departure from the lab billing process of the past?
Integrated lab billing is achieved when modules for both laboratory information system (LIS) and laboratory revenue cycle management are united within one unified laboratory software system database and infrastructure.
Unlike non-integrated lab RCM systems that are interfaced with disparate laboratory information systems and require more labor, have limited scalability, and are subject to data silos and compliance issues, integrated lab RCM systems create 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 components at this initial stage, and automation and transparency throughout the RCM cycle, a lab’s clean claims ratio greatly increases, compliance liability goes down, and revenue leakage is stopped in its tracks.
LigoLab’s Integrated Laboratory Revenue Cycle Management 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 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, remittance, and processing data.
The Billing Encounter is the driving force behind the logic that simultaneously supports LIS and RCM module processes and the entire LIS & RCM lifecycle of a case.
A Deeper Dive into the Advantages of Integrated Laboratory Billing
Now let’s delve a little deeper into the differences between the integrated laboratory billing offered by LigoLab and non-integrated lab revenue cycle management.
An integrated laboratory billing solution has an unlimited amount of operational configuration and customization options, making it adaptable to all aspects of laboratory workflow.
Non-integrated laboratory billing solutions have limited functionality and lack configuration flexibility.
An integrated laboratory billing solution removes common lab billing problems like data silos and constant synchronization with a unified approach that produces significant revenue growth.
The combination of rigid modules and separate laboratory software systems for LIS and RCM functions requires constant synchronization with non-integrated laboratory billing solutions (and no guarantee of data integrity as the data moves from one system to the next).
An integrated laboratory billing solution with embedded data validation tools backed by powerful third-party software vendors results in a much higher First-Pass Resolution Rate (FPRR) than the industry benchmark of between 85 and 95 percent.
Non-integrated laboratory billing solutions are labor-intensive, have error-prone data validation processes, and limited visibility of both laboratory workflow and data processing.
An integrated laboratory billing solution has synchronized workflow queues that are geared toward 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 systems.
An integrated laboratory billing solution with automation enables the elimination of manual and repetitive tasks and promotes scalability and maintainable fiscal growth.
Non-integrated laboratory billing solutions have higher risks associated with scaling, unanticipated industry changes, and longer vicious business cycles.
An integrated laboratory billing solution can support 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.
More Reasons Why You Should Consider Partnering with LigoLab for 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 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 workflow whenever possible, our partner labs consistently report manual labor reductions of around 30 percent.
At LigoLab, we’ve provided flexible all-in-one LIS systems and lab RCM 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 software 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.