OCL LIS Billing Module
 
The OCL LIS Billing Module is a complete and comprehensive Revenue Cycle Management solution designed specifically for the laboratory industry. Built to simplify billing workflows, improve reimbursement, and reduce claim rejections, this module gives laboratories the flexibility and control they need to manage client, patient, and insurance billing efficiently from within the LIS.

With powerful automation, customizable rules, advanced reporting, and integrated payment tools, the OCL LIS Billing Module helps labs streamline financial operations while maximizing revenue and minimizing billing errors.

Key Features Include:

• Invoice Creation

  • Generate invoices for:

    • Clients

    • Patients

    • Insurance companies

  • Support for standard charges or per diem rate billing.
     

• Flexible Charge Configuration

  • Configure different charge types directly in the LIS, including:

    • Tests

    • Organisms identified

    • Susceptibility charges

    • Travel fees

    • Additional charges

    • Venipunctures and other service-based fees

  • Charges are properly categorized, making it easier to separate actual tests performed from additional services.
     

• Unlimited Fee Schedules

  • Create custom fee schedules and pricing rules based on:

    • Charge or CPT code

    • Bill-to: Client, Patient, or Insurance

    • Bill type: Medicare, Medicaid, Commercial Insurance, and more

    • Payer or insurance company

    • Client

    • Patient

    • Place of Service (POS)

    • Type of Service (TOS)
       

• Medical Necessity Rules

  • Create permitted diagnosis rules to help comply with medical necessity requirements.

  • Reduce claim rejections and denials based on:

    • CPT codes

    • Patient gender

    • Bill type

    • Payer

    • Patient-specific rules
       

• Automatic Modifier Rules

  • Apply billing modifiers automatically when needed.

  • Help maximize reimbursement and reduce denials using rules based on:

    • Charge

    • Frequency

    • Bill-to type

    • Bill type

    • Payer

    • Client

    • Patient
       

• Panel Billing Rules

  • Break down custom panels into billable charges.

  • For example, a General Health Profile may include CBC, CMP, UA, and A1C.

  • Bill the client as one panel or bill the insurance company by individual components.
     

• Advanced Billing Rules

  • Generate invoices or claim charges based on:

    • Specific tests

    • Test counts

    • Toxicology classes
       

• Collections Management

  • Manage past-due invoices directly in the LIS.

  • Automatically generate customizable patient collection letters based on days past due.

  • Customize letters and invoices to help improve collections and reduce revenue loss.
     

• Form Generation

  • Generate important billing forms, including:

    • ABN forms

    • CMS-1500 forms
       

• Advanced Transaction Search and Audit

  • Quickly search billing transactions.

  • Access detailed audit tools to support transparency and compliance.
     

• Customizable Billing Reports

  • Build advanced reports using simple drag-and-drop tools.

  • Monitor billing quality, performance, and operational efficiency.
     

• Automated Patient Payment Portal

  • Offer patients a fully automated payment portal for convenient online payments.

 

OCL LIS also offers an intelligent AI Billing Agent designed to support and streamline laboratory billing operations. This advanced tool can assist with patient eligibility review, provide guidance on billing coding, and offer helpful denial advice to reduce rejections and improve reimbursement outcomes. By adding AI-powered support to the billing workflow, laboratories can work more efficiently, minimize manual effort, and make more informed billing decisions.​

Request a demo today to see how the OCL LIS Billing Module can help your laboratory improve billing accuracy, increase revenue, and streamline your entire revenue cycle.