The Challenge

After merging, Northwest Pathology faced a significant problem: their revenue cycle took a hit due to fragmented data systems. The integration of multiple Laboratory Information Systems created data inconsistencies, slowed down reporting, and increased claim denials. Their outdated legacy system made it tough to predict revenue accurately and manage billing, leading to financial instability.

The Approach

Gistia began by conducting a Revenue Cycle Assessment to identify key areas where financial losses were occurring. This assessment provided critical insights into revenue leakage, claim denials, and billing inefficiencies.

Following the assessment, Gistia implemented the Gistia Order Management Platform to directly address these challenges. Centralizing data from various laboratory and billing systems into a single, reliable Data Store was crucial. With the Gistia Order Management Module and Gistia Results Delivery Module—both integral parts of the Gistia Tech Stack—data processing became more streamlined, ensuring that financial and operational data were consistent and accurate.

The platform’s advanced Revenue Cycle Assessment tool also pinpointed previously unnoticed areas of financial loss. By integrating with the lab’s CRM and automating the processing of HL7 messages, human errors were minimized, significantly reducing the likelihood of claim denials.

The Results

The impact was immediate. Northwest Pathology saw a marked reduction in revenue cycle losses. The new system drastically reduced billing errors and claim denials. The centralized management of data enabled better revenue forecasting, improving cash flow and financial stability. Ultimately, the lab regained control over its revenue cycle, reversing losses, and establishing a foundation for sustained financial health.