The Power of Integration: Unleashing the Potential of LigoLab's LIS & Lab RCM System
June 14, 2023
This summary aims to highlight the distinct benefits that stem from utilizing an integrated Laboratory Information System (LIS) and Laboratory Revenue Cycle Management (RCM) system. However, it should be noted that this overview does not delve into the exhaustive array of features and capabilities inherent to the advanced lab RCM module of LigoLab Informatics Platform.
By synthesizing the critical functionalities of both a LIS system and a laboratory billing system into a single, cohesive and comprehensive platform, we’ve managed to elevate the industry standards for laboratory information system software. The purpose of this post is to underscore LigoLab's competitive edge over fragmented, non-integrated LIS systems, emphasizing the value of a streamlined, unified approach to LIS software.
The harmonious integration of the LIS system and billing software for labs provides an elevated, seamless user experience, enabling more efficient workflows, greater data accuracy, and ultimately, better patient care. With our integrated pathology management software, we demonstrate LigoLab's commitment to innovation, efficiency, and growth in an ever-evolving healthcare landscape.
Lab Revenue Cycle Management - Balancing Upfront Costs with Long-term Goals
When evaluating simpler and more affordable laboratory billing solutions, it's essential to consider not just the upfront cost savings, but also the potential long-term ramifications of that choice. Here are a few critical points to bear in mind:
- Additional labor costs: A simpler lab billing system might not include features that automate routine tasks, which means additional manual work for your staff. Over time, these costs can add up, offsetting the initial savings.
- Compliance and accuracy: Human error is an inevitable part of manual data entry and workflows, leading to potential compliance issues and inaccuracies in billing and coding. Mistakes in this area can lead to claim denials, delayed payments, and in worst-case scenarios, legal issues due to non-compliance with healthcare regulations.
- Scalability: Cheaper and stand-alone lab RCM systems may not scale well as your organization grows. If the laboratory billing system cannot handle increased volume or complexity, you might have to invest in a new RCM software solution sooner than expected, making the cheaper option more expensive in the long run.
- Integration challenges: Simpler billing software for labs may not integrate smoothly with your existing LIS system and require synchronization of master files (clients, providers, tests, pricing, etc.) which could lead to disjointed workflows, inefficiencies, and increased errors.
- Limited support and training: Legacy RCM tools often have limited customer support and training options. This could leave your staff struggling to use the lab billing system effectively, leading to lower productivity and potential mistakes.
- Patient satisfaction: A robust RCM solution not only handles lab billing and insurance claims efficiently but also ensures a smooth and transparent RCM process for patients and clients. A cheaper, less efficient lab billing software could lead to errors and confusion, negatively impacting patient satisfaction. Also, patients increasingly want clear, up-front information about costs, and an inferior RCM cycle might not provide the necessary tools for price transparency. This could impact patient and customer trust and satisfaction in the long run.
- Transparency and a single source of truth: In today's digital health landscape, having a single source of truth is vital for managing and reporting accurate information. A stand-alone RCM solution will not have the capability to centralize all your data, leading to fragmented and inconsistent information across various systems. This lack of a single source of truth can impede transparency, hamper decision-making, and affect the overall efficiency of your operations. Moreover, transparency is crucial, not just for internal operations, but also for the patients and clients you serve.
A robust RCM process can consolidate all your financial data, providing a single source of truth. It can help maintain data integrity, promote transparency, facilitate more accurate reporting and analysis, and ultimately, lead to better business decisions and improved patient satisfaction.
Therefore, while the initial cost is a crucial factor, it is just as essential to consider the total cost of ownership, including potential hidden costs and pitfalls. A more comprehensive RCM solution is likely to be more expensive initially, but it will offer better value over time by improving efficiency, maximizing automation, increasing profit, ensuring compliance, and enabling growth.
Lab Billing Solutions: Upfront RCM Tools that Ensure Order Data Accuracy
As one might imagine, many advantages come with starting the lab RCM process as the lab order is created. Legacy and stand-alone laboratory billing solutions are flawed because they don’t have the RCM tools to catch upstream mistakes before they cause downstream denials. On the other, LigoLab’s advanced LIS software that’s fully integrated with a robust lab revenue cycle management module can offer numerous RCM tools that prevent mistakes and speed up the laboratory billing process.
- Insurance eligibility verification: This crucial process can be initiated automatically or manually at the very beginning of test processing and continued seamlessly throughout the lab billing workflow. With the Insurance Eligibility Checking tool from LigoLab, integrated directly into the order entry workflow, you significantly enhance the rate of clean claims and reduce the likelihood of denials at later stages. In response to eligibility verification outcomes, tests can be appropriately redirected to reference laboratories, ensuring an optimized and efficient management of workload.
- Insurance discovery: The Insurance Discovery tool from LigoLab offers flexibility and can be implemented at any point within the laboratory workflow. The LIS system can be configured to trigger the tool automatically in instances where eligibility verification fails or when insurance details are missing. The responses garnered from the Insurance Discovery tool can, in turn, dictate alterations to the test workflows, ensuring an adaptable, responsive, and efficient laboratory billing process.
- Advanced beneficiary notice (ABN): The generation of an ABN involves a sequence of steps: the unbundling of the test panel, the CPT code assigned to the test, the application of a specific pricing policy for tests, and finally, the presentation of the ABN document to the patient for their signature. LigoLab’s integrated RCM module efficiently facilitates the second and third steps in this process.
- Preauthorization: Based on set rules and validations configured within the LIS system, tests requiring preauthorization are held until the necessary preauthorization number is provided. Both the preauthorization number and the corresponding CPT codes are then communicated to the RCM module.
- Test addition and deletion: The process of adding or deleting tests can be performed at any point in the laboratory workflow, even after charges have been submitted to the payer. The addition or deletion of new tests may instigate a coding review, leading to subsequent modifications of the client invoice or claim.
- Payer sequence synchronization: The payer sequence indicator is fully synchronized within LigoLab’s RCM module. Any changes in the payer sequence that aren't synchronized could potentially trigger lab billing errors.
Lab Billing Solutions: Integrated Master Files Management
In an integrated laboratory workflow, Master Files are critical. They encompass the various setup parameters (including different data fields and flags) that are integral to the system's functionalities. In stand-alone LIS and RCM systems, these files must be manually synchronized to ensure seamless laboratory workflow. However, unsynchronized data modifications can trigger unpredictable workflow outcomes, causing inefficiencies and potential errors.
In contrast, with LigoLab's integrated LIS system, this manual synchronization for laboratory billing becomes obsolete. The shared Master Files data eliminates the need for duplicate effort and reduces the risk of discrepancies, ensuring a consistent, reliable laboratory workflow.
Typical synchronization requirements in stand-alone LIS systems and laboratory revenue cycle management systems often include:
- Master payer list: Reflects all insurance carriers.
- Client/client group list: Lists all clients and groups for accurate billing and reporting.
- Ordering/rendering provider list: Houses details about providers who order or render services.
- Rendering facility list: Captures data about where services are performed.
- Place of service list: Contains information about where patients receive services.
- CPT/custom CPT list: Maintains records of all procedure codes.
- Modifiers/custom modifiers list: Provides an overview of all modifiers used for coding.
- System security user profiles/credentials list: Contains access and security details for users.
In LigoLab’s pathology reporting software, these lists are harmoniously integrated, reducing administrative overhead and increasing workflow efficiency.
Lab Billing Solutions: Patient Demographics Verification
Utilizing RCM tools, verification of patient demographics may be conducted at the earliest stages of test processing, which makes it possible to bypass demographics review in the stand-alone lab RCM workflow. This results in extensive automation of the laboratory billing process including insurance, client, and self-pay billing.
Lab Billing Solutions: Seamless Automation of Coding
Leveraging a LIS system with an integrated platform provides an unparalleled advantage in terms of workflow visibility. Such comprehensive oversight eliminates data silos and facilitates real-time tracking of each procedure within your laboratory operations.
When it comes to coding, this integrated approach transforms the traditionally manual and error-prone process into an automated, streamlined, and efficient task. Every procedure is captured and coded accurately, ensuring no revenue leaks due to uncoded or under-coded procedures. This in turn not only maximizes your revenue but also increases your operational efficiency, giving you more time to focus on your core laboratory services.
In essence, the integrated platform creates a transparent and seamless environment, ensuring every step is accounted for, every procedure is accurately coded, and every potential revenue opportunity is captured. This is the power and promise of a unified, integrated LIS system with a laboratory billing solution.
The power of the unified LigoLab platform is in its ability to seamlessly utilize revenue cycle management (RCM) tools, thereby facilitating precise pre-coding in the laboratory information system (LIS) module. This ensures accurate data transfer to the billing encounter data entity within the RCM module.
Under certain scenarios, the coding processes are initiated even before data is shared with the RCM module. This coding can occur on various levels:
- Test level (for example, flow cytometry in the LIS system)
- Specimen/site level (such as immunochemistry in the LIS system)
- Encounter level (within the RCM module)
Tests and procedures processing: Leveraging the platform's integrated feature ensures that all laboratory tests and procedures are accounted for and billed accurately, eliminating the risk of missing a single case.
Test Result Monitoring: Any abnormal test results will trigger designated rules and automated processes in relation to the respective coding processes, ensuring that each unique scenario is handled appropriately and efficiently.
The integrated platform also offers the convenience of easy access to post-coding reviews for pathologists or administrative personnel. This enables further scrutiny and ensures the accuracy of codes before they are finalized, enhancing revenue integrity and mitigating compliance risks.
Lab Billing Solutions: Simplified Data Access and Sharing
An integrated LIS system with RCM tools enhances the ease of data access and sharing. It readily provides access to critical information such as specimen data, reports (including amendments), images, scanned documents, and the sources of CPT code assignments (test/panel).
Lab Billing Solutions: Streamlined Access for Pathologists and Executives
The LigoLab platform goes a step further to create consolidated reports and dashboards, drawing upon the integrated laboratory information system (LIS) and revenue cycle management (RCM) data. This means that department managers, pathologists, and executives can easily review and analyze critical information to gain insight into their operations. Furthermore, the convenience of unified single-system credentials facilitates secure remote access from any device, adding another level of flexibility to your operations.
A Comprehensive Laboratory Information Management System
Since 2006, LigoLab has specialized in the development and licensing of laboratory informatics, providing comprehensive and agile solutions for anatomic, clinical, and molecular laboratories (click here to learn how the company was founded). The LigoLab LIS & RCM Informatics Platform is driving efficiency, productivity, market differentiation, and growth in hundreds of laboratory facilities nationwide.
LigoLab’s LIS module first debuted in 2006 with the flagship anatomic pathology solution released in March of 2007. The RCM module of the LigoLab platform was launched in 2019. TestDirectly, LigoLab’s direct-to-consumer software solution marked a major milestone for the company’s vision of delivering a complete platform with infinite configurability when it debuted in the spring of 2020.
This fully-integrated multi-specialty platform optimizes efficiency and performance to drive all the features and modules lab organizations need to succeed, all without the need to interface multiple third-party modules or systems, middleware, or manual workarounds. Fueled by automation, laboratory productivity goes way up, turnaround times become much faster, and human error resulting in lost or mislabeled samples is drastically reduced with this unique-to-the-market all-in-one laboratory software solution.
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