Webinars
Outsourced vs. In-House Laboratory Billing: How to Make the Right Choice for Your Lab
TRANSCRIPT
Michael Kalinowski:
Welcome to our LigoLab webinar: Outsourced vs. In-House Laboratory Billing. If you work in a lab, this topic, laboratory billing, and lab revenue cycle management have likely come up before. Today, we’ll dive into one of the most important subjects for any laboratory business.
We’ve assembled an experienced panel to guide this lab RCM discussion.
I’m Michael, part of LigoLab’s Communications and PR team. Joining me today:
- Mick Raich – A lab RCM expert with decades of experience in RCM process optimization.
- Denise Mazon – A laboratory revenue cycle management specialist who’s worked on the outsourced and in-house sides of lab billing during her career.
- Aram Avakyan – An RCM software product specialist with LigoLab who brings clinical and tech expertise to the lab billing table.
Learn More: Maximizing Your Lab’s Profitability: The Case for In-House Lab Billing
Introductions
Mick Raich:
I’ve been working in lab revenue cycle management for over 22 years. I focus on the full RCM process - from charge capture to collections - helping labs understand what’s working, what’s not, and how to improve.
Denise Mazon:
I’ve worked in healthcare revenue cycle management for 34 years, spanning emergency room registration to senior leadership. Over 20 of those years have been in the lab space, managing in-house and outsourced laboratory billing teams. I recently joined LigoLab after collaborating with RCM software vendors on their laboratory billing solutions.
Aram Avakyan:
I come from a healthcare background as a clinical pharmacist and have a deep interest in tech. At LigoLab, I bridge the gap between healthcare operations and pathology lab reporting software innovation. I understand the payer and patient sides, helping labs streamline their lab billing through smart RCM technology.
Why Lab Billing Matters
Michael Kalinowski:
Let’s start with the big picture - why should labs care so deeply about how their lab billing is managed?
Mick Raich:
Labs must be able to invoice for their services to survive. I’ve seen great labs with cutting-edge diagnostics fail because they couldn’t bill efficiently. Lab revenue cycle management is foundational to a lab’s success, and that’s why this conversation matters.
Denise Mazon:
Agreed. Laboratory billing is critical. It directly impacts a lab’s success. There are so many moving parts. If you don’t handle it properly, whether in-house or outsourced, it’s a serious risk to your business.
Aram Avakyan:
Without consistent revenue, labs can’t grow - or even survive. As testing volume increases, getting reimbursed efficiently becomes even more essential. You need the right revenue cycle management tools and processes to stay ahead.
Learn More: Laboratory Billing 101 - The Differences Between In-House Billing and Outsourced Billing Services
The Current State of Laboratory Billing Solutions
Mick Raich:
It’s not 2020 anymore - costs are up 20 percent or more, but labs are still stuck with fixed payer fee schedules. Payers now change their rules via newsletter multiple times a year. You must be on top of everything and make decisions in real time, not 30 days later.
Denise Mazon:
Absolutely. It used to be that payer rules changed annually - now it’s monthly, even weekly. Often, you don’t know about changes until the denials start rolling in. Labs also rely on external requisitions for lab billing info, which are often incomplete. Add staffing shortages, and it’s a tough environment.
Aram Avakyan:
Denials create a ripple effect - time lost, productivity down, revenue missed. You need to be preemptive, not reactive. That means automating validations, using data, and streamlining everything before the claim even goes out.
Learn More: Reduce Denials and Stop Revenue Leakage With Integrated Laboratory Billing Management
Outsourced Lab Billing: Pros and Cons
Denise Mazon:
There are good agencies out there, but you must find one that truly understands labs. Outsourcing can relieve staffing pressures and reduce infrastructure costs, but the trade-off is control. You’re not their only client.
Mick Raich:
Exactly. I’ve audited dozens of laboratory billing companies. Staffing turnover, consolidation, and lack of prioritization can be issues. Some billers make you wait months for support - by then, your AR is a mess. It can work for smaller labs, but you give up autonomy.
Learn More: Clinical Laboratory Management Solutions for Lab Revenue Cycle Management (Lab RCM)
In-House Lab Billing: Pros and Cons
Aram Avakyan:
In-house lab billing gives you control and transparency. You manage your goals, team, and workflow directly. The challenge is cost and scalability. Training and systems investment are major factors.
Mick Raich:
If you can manage in-house laboratory billing within two percent of the cost of outsourcing, it may be worth it for the autonomy and knowledge retention. But don’t forget hidden costs - space, technology, internet, staff time. Most labs underestimate these.
Learn More: The Top Five KPIs: Driving Successful Lab Revenue Cycle Management
Evaluating Laboratory Billing System Options
Michael Kalinowski:
One question we received: Aren’t some of the cons of outsourced laboratory revenue cycle management speculative if you partner with the right RCM management company?
Denise Mazon:
Yes, if you find the right partner. Ask for references. Don’t settle for a cherry-picked list. Speak to clients who’ll give you the honest pros and cons.
Mick Raich:
Visit their offices. Meet the people who’ll be handling your money. Also, read the contract thoroughly. Understand your rights, costs, and liabilities if mistakes happen.
Learn More: Six Reasons Why You Should Choose an Integrated Laboratory Billing Solution for Your Medical Lab
Common Lab RCM Problems
Aram Avakyan:
Incomplete data, labor inefficiencies, lack of integration, and poor real-time analytics. All these are common laboratory billing issues. Many labs still operate with rigid, disconnected laboratory software systems.
Mick Raich:
Don’t forget unbilled claims. Labs often miss 3-to-5 percent of billable tests. If you write off AR too early, you’re throwing money away. Real-time laboratory billing system automation is key.
Denise Mazon:
Lab billing is more complex than many think. Often, the problems aren’t even caused by the lab, but by missing documentation from providers. That’s why strong processes and laboratory billing solutions with automation are so valuable.
Learn More: Laboratory Billing Automation: Boosting Efficiency & Clean Claim Rates
The Case for Laboratory Billing System Automation & Analytics
Denise Mazon:
Laboratory billing system automation removes repetitive tasks and frees staff to focus on more critical areas. Eligibility checks, insurance discovery, workflow queues - all of it helps.
Aram Avakyan:
You need advanced RCM tools that provide real-time data and are configurable. Dashboards are a must. With the right analytics, you can make decisions faster and more accurately.
Mick Raich:
Use your lab RCM data to analyze profitability by CPT, ICD, payer, and even draw center location. You can’t grow intelligently without that insight.
Learn More: The Power of Integration: Unleashing the Potential of LigoLab's LIS System & Lab RCM Platform
What Growing Labs Need Most
Aram Avakyan:
Scalability and visibility. Can your laboratory billing system handle growth without breaking? Can you adjust quickly as your testing volume increases?
How LigoLab Supports Optimized Laboratory Billing Solutions
Aram Avakyan:
LigoLab offers built-in RCM tools for real-time eligibility checks, claim validation, denial management, and more within one unified LIS laboratory information system software and lab billing platform.
Denise Mazon:
The LIS software and lab RCM integration is a game-changer. You don’t have to bounce between systems. It’s all there - patient results, insurance info, billing documents - accessible in one place.
Learn More: Comparing the LigoLab Informatics Platform with Legacy Laboratory Information System Software
Key Lab Billing Takeaways
Mick Raich:
- Do your due diligence - don't choose based on cost alone.
- Maximize automation and efficiency.
- Be innovative - consider new models and partnerships.
Industry Insights: Navigating the Coding Minefield: Labs Struggle with RCM Rejections Amid Rising Scrutiny from Payers
Q&A Highlights
Q: Can laboratory billing automation really help reduce denials?
A (Aram Avakyan): Yes, lab revenue cycle management tools like auto-coding and claim scrubbing identify mismatches before submission. Preemptive validation is crucial.
Q: How can labs use artificial intelligence (AI) in lab RCM?
A (Mick Raich): Think “your bot vs. their bot.” Labs need modern RCM tools to level the playing field.
A (Denise Mazon): AI can handle repetitive tasks, freeing staff for more critical work. It’s often more cost-effective than hiring an additional full-time equivalent (FTE).
Industry Insights: The AI Revolution in Laboratory Billing: A Game Changer for 2025 and Beyond
Michael Kalinowski:
Thanks again to Mick, Denise, and Aram for sharing their time and expertise. If you'd like to continue the conversation, contact us at info@ligolab.com or connect directly via the QR codes on screen. Stay tuned for more webinars from LigoLab, and thanks again for attending.