How to Modernize Your Laboratory Order Process

Medical laboratories generate and manage large volumes of tests and patient data. So it's no surprise that these same labs also experience some of the highest denial rates in healthcare.  

The average hospital faces a denial rate of between 6% and 13%, according to HealthCare Finance. 

Labs, on the other hand, face much higher average denial rates of 15% for in-network claims and 30% for out-of-network claims, according to MLO. 

A decade or two ago, most labs would have shrugged their shoulders and continued with business as usual -- armed with robust budgets and sizable margins, they would simply ignore these denials, assuming that the effort to resubmit wasn't worth the time or effort.  

They might have been leaving money on the table. But the business was still profitable.  

However, there's more pressure now than there was then.  

Margins have shrunk, the Affordable Care Act, No Surprise Billing Act, & Interoperability and Patient Access Rule have created new complexities and compliance obligations, and payers are getting more aggressive in recouping costs. 

Labs need to proactively improve their RCM workflow to protect themselves against continuing trends like payer reimbursement cuts, custom payer requirements, fast-changing rules, increased regulations, and the continued growth of patient payment responsibility.   

EHRs (Electronic Health Records) are a step in the right direction, yet implementing new technologies doesn’t always solve workflow issues (one of the main sources of RCM bottlenecks).  

In fact, poorly integrated IT can actually hinder laboratory workflows by making it necessary for workers to duplicate data across multiple applications or log in and out of several systems to find the relevant laboratory data they need to inform clinical decision-making.  

So what should labs do to streamline their order processes and improve their denial rates in today's high-pressure ecosystem? 

Here's what we recommend. 

Automate Manual Tasks

A major source of inefficiency and errors in the laboratory order process is reliance on manual tasks.  

For example, a common workflow issue is that when an order arrives from a referring physician, it must be manually entered into the lab information system (LIS).  

This task is often completed by a clerk who transcribes the order from the paper requisition.  

The process is time-consuming and error-prone, and it can often lead to delays in getting the test results back to the physician.  

It would be much more efficient if the order could be electronically transmitted from the physician's office directly into the LIS.  

Fortunately, there are many software solutions that can automate this process, as well as other manual tasks in the laboratory order process.  

For example, some software solutions can automatically match laboratory orders with the correct patient records in the EHR.  

This helps to ensure that the test results are properly attributed to the correct patient and prevents mix-ups that could lead to serious clinical errors.  

Other software solutions can automatically generate billing codes for laboratory tests and send them to the practice's billing system.  

This can help to ensure that the correct codes are used and that the practice is reimbursed for the tests that were performed.  

Still, other software solutions can help to automate the process of verifying insurance benefits and authorizations.  

By automating these manual tasks, laboratories can significantly improve their efficiency and accuracy, and they can free up staff to focus on more important tasks. 

Go Paperless

Another common source of inefficiency and errors in the laboratory order process is the use of paper forms.  

If you want to create a positive patient experience,  it is important to go paperless.  

It will also help reduce the chance of transcription errors and make it easier to track laboratory orders.  

There are many software solutions that can help you transition to a paperless environment.  

For example, some solutions can provide digital forms that can be completed by patients on their own devices before they arrive at the laboratory.  

This helps to ensure that the correct information is collected and reduces the chances of errors caused by handwriting.  

Other software solutions can automate the process of routing orders to the appropriate departments within the laboratory, which can help to improve turnaround times for test results. 

Still, other software solutions can help you track and manage laboratory inventory, so you can be sure that you always have the supplies you need on hand.  

By going paperless, laboratories can improve their efficiency and accuracy, and they can provide a better experience for their patients.

Leverage LIMS for Decision Making

Laboratory information management systems (LIMS) can play a key role in helping laboratories to streamline their order process.  

For example, LIMS can be used to track the status of laboratory tests and to provide information on the availability of test results.  

This can help laboratories to make better decisions about when to order tests and how to prioritize them.  

In addition, LIMS can be used to generate reports on the performance of the laboratory.  

This information can be used to identify areas where the laboratory could improve its efficiency or accuracy.  

By using LIMS, laboratories can make their order process more efficient and effective, and less error-prone.

Adopt Lean Methodologies

Another way to streamline the laboratory order process is to adopt lean methodologies.  

Lean methodologies are designed to help organizations eliminate waste and improve efficiency.  

There are many different lean methodologies, but one of the most commonly used is called value stream mapping.  

Value stream mapping is a system that can be used to visualize the flow of information and materials through a process.  

It can be used to identify bottlenecks and areas of waste in the process.  

Once these problems have been identified, they can be addressed so that the process can be made more efficient.  

Lean methodologies can be very effective in helping laboratories to streamline their order process.  

By using lean methodologies, laboratories can identify and eliminate waste, improve efficiency, and make their order process more effective. 

Focus on Digital Solutions

In today's world, many of the tasks that were once done manually can now be done digitally.  

This is especially true in the field of laboratory information management.  

As we've discussed, there are many different digital solutions that can help laboratories to streamline their order process.  

By using digital solutions, laboratories can eliminate the need for paper requisition forms, make their order process more accurate and complete, and make it easier to track the status of laboratory tests. 

Seek Technology Partners

Many laboratories struggle with the task of keeping up with the latest technological advances.  

This can be a daunting task, but it is important for laboratories to stay current with the latest technology advancements if they want to streamline their order process.  

One way to do this is to seek technology partnerships.  

Building technology partnerships is all about selecting vendors who can help you integrate their systems as effectively as possible. Before choosing, ask potential vendors to conduct a clinical workflow assessment so that you can see how their tech will practically impact your lab.  

Also, make sure they have experience working with medical laboratories.   

By seeking technology partnerships, laboratories can stay current with the latest technology advancements and make their order process more efficient and effective. 

Final Thoughts

There are many different ways that laboratories can streamline their order process.  

By using LIMS, adopting lean methodologies, focusing on digital solutions, and seeking technology partnerships, laboratories can make their order process more efficient and effective. 

Streamlining the laboratory order process can help laboratories to improve their efficiency and accuracy, and to make better use of their resources -- which means better profit margins and less wasted human capital.