The LIS & RCM Operating Platform from Los Angeles-based LigoLab is fully integrated and features targeted automation that enables users to identify and process thousands of uninsured covid-19 patients in just minutes. This has proven to be a major advantage for laboratories across the country that have boosted their diagnostic testing capacity to meet the public demand.
The Health Resources & Services Administration (HRSA) program provides claims reimbursement to healthcare providers for the testing of uninsured individuals for covid-19. The program was first established by the US Department of Health and Human Services (HHS) in February of 2020. For laboratories, this is a time-consuming and labor-intensive process that puts added pressure on their billing departments. For LigoLab users, however, the process is largely automated and can be completed in just a few clicks.
“We’ve automated much of the HRSA reimbursement procedure for our lab partners,” says Farzad Abdi, LigoLab’s billing manager. “Our platform automatically initiates insurance discovery service followed by an eligibility check, and if no insurance is found, LigoLab RCM runs a built-in dynamic report that identifies patients without insurance and generates an export file which is uploaded to the HRSA website. Later, a batch file is imported back into LigoLab and the RCM assigns a temporary HRSA ID to the patient encounters automatically.
The alternative is copying and pasting the required patient information into the LIS manually one by one, a procedure that’s prone to error.
“With this level of automation, laboratories can handle a much higher capacity for claims without having to expand their billing departments,” continues Abdi, who estimates that more than 10% of covid-19 claims fall into the HRSA reimbursement category. “For high-volume laboratories, this translates into potentially thousands of daily claims that can now be processed in a matter of minutes, rather than taking several hours to complete the task.”
“LigoLab RCM is enhanced by a specialized and customizable rule engine that handles client billing policies automatically,” says Abdi. “The HRSA workflow is just one example. We can build automation to support even the most complicated billing policies, and we can do it in a matter of hours because we have a well-trained and experienced support staff.”
Abdi says LigoLab’s RCM team continues to build out multiple automation rules to help all of its lab partners manage the escalated number of covid-19 claims. He says it’s now possible to largely automate the client billing workflow, and that most insurance claims are being processed without human intervention.