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The Value of a Patient to Payment Process for Next-Gen Sequencing and Pharmacogenomics

  • Vice President of Sales, XIFIN

The volume of next-generation sequencing (NGS) and pharmacogenomics (PGx) tests is growing every year. According to the Next Generation Sequencing Market Report published by Allied Market Research, the global NGS market is expected to reach $12.8 billion by 20221. These are high-value tests in terms of both diagnostic worth and cost. As such, laboratories need to understand the pathway to reimbursement for these relatively expensive tests. Also, NGS and PGx-focused laboratories must be equipped to address the unique data and workflow management, reporting, and reimbursement compliance needs associated with this highly advanced testing.

Choosing the right laboratory information system (LIS) can help ensure a smooth process from test order to reimbursement. Not many LIS’ can handle the complexity of NGS or PGx in a commercial laboratory environment. Test ordering, including prior authorization confirmation, user-configurable workflow processes, NGS platform connectivity, reporting, and billing integration are all critical components of an effective LIS for NGS and PGx labs. The right LIS facilitates an open yet secure exchange of diagnostic, financial, and clinical information.

NGS and PGx labs need an LIS that provides the configurable wet lab workflow and protocols, instrumentation integration, and batch handling. Additionally, the LIS must also be able to connect to bioinformatics platforms to accurately disseminate post-analytical data and report results at the specimen level while keeping an audit trail of the entire process.

To complete the patient-to-payment process, integration with prior authorization services such as Glidian and revenue cycle management systems such as XIFIN RPM with built-in processes to manage pre-authorizations and appeals must be easy. XIFIN LIS can do just that, and more. Architected for interoperability, the integrated NGS and PGx workflow modules can be used in conjunction with other XIFIN LIS modules or be integrated with an already existing laboratory information system. 

XIFIN LIS includes a full array of DNA sequencing workflow capabilities, including:

Reimbursement Workflow

Automate the exchange of prior authorization and reimbursement information between the LIS and revenue cycle platforms.

Configurable Batch Processing

Process, review and report groups of specimens by batch for efficient sample management.

Connectivity and Interoperability

Build and manage custom protocols for managing detailed processing workflows including reagent tracking, QC assignment and custom calculations.

Plate Mapping and Management

Create plate protocols to manage and view specimen and well assignments within plates.

Protocol Management

Build and manage custom protocols for managing detailed processing workflows including reagent tracking, QC assignment and custom calculations.

Customizable Reporting

Deliver custom branded reports that synthesize and display gene and variant detail, complex drug information and references, graphical charts, and calculated probable outcome scores.

XIFIN LIS is an award-winning SaaS-based LIS that offers multi-specialty workflows and collaboration tools necessary to support NGS and PGx laboratories. Learn more about XIFIN’s purpose-built LIS in our white paper titled, "The Build vs. Buy Conundrum of Laboratory Information Systems."

Published by XIFIN
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