Enzo Clinical Labs Installs RICAR for Requisition and EOB Workflow and Content Management

Farmingdale, NY-- Enzo Clinical Laboratories chooses Freedom Imaging Systems for requisition and EOB document management and workflow.

In 1995, Freedom installed RICAR (Record Image Capture and Retrieval) at its very first customer, a clinical laboratory. Almost twenty years later, Freedom continues to provide relevant and cost-saving solutions for the laboratory industry.

Just like the laboratory is a different place than it was twenty years ago, so too has Freedom's RICAR software evolved with the demands of the healthcare industry and advances in technology. Recently, Freedom worked with Enzo's revenue cycle management team to develop a more efficient and effective digital billing workflow driven by HL7 files.

Within every laboratory is a Lab Information System (LIS) which contains all of the patient and testing information relevant to the tests performed in the lab. From lab testing to billing, information in the LIS is imperative to the processes of the lab. Most Lab Information Systems produce HL7 files, a healthcare industry standard file for transmitting electronic health information. Based on these files and the intelligence of RICAR, Freedom developed an electronic, business process management-driven workflow for the Enzo revenue cycle management team. Read on for more details of the implementation.

Immediately after processing, requisitions are scanned by laboratory staff. FreeScan, RICAR's scanning software application, reads the accession number from the barcode of each document. After scanning, each requisition is immediately available for look up by accession number using FreeView, RICAR's viewing software. Each requisition is also sent to a work queue within RICAR's workflow software, FreeWf, where it is held awaiting a corresponding HL7 file. An initial HL7 file with patient demographic information is sent from Enzo's Lab Information System and is consumed by RICAR to populate indexing fields for each requisition, allowing it to be searched and retrieved by patient last and first name, pathology case number, date of birth, collection date, and client information. The presence of a case number in this initial file also sends those documents (anatomic pathology requisitions) to a separate holding queue, awaiting a final testing flag before released to data entry. General requisitions are sent to a data entry queue immediately after an HL7 is received, and are data entered by billing processors.

Once Data Entry staff key requisitions, they are sent to another holding queue where they await a third HL7 file from Enzo's billing system. This third HL7 file contains two important pieces of information - edit reasons or a final billing complete flag. If for some reason a claim cannot be generated after data entry (i.e. there is a piece of missing information), edit reason codes are created within the billing system. A few examples of edit reasons include "Missing Diagnosis Code", "Missing Date of Birth", "Missing Guarantor", and "Missing NPI". Enzo's billing system transmits these edit reason codes within the HL7 file. Freedom processes the HL7 and moves the corresponding requisition to a queue specific to the edit reason code. The Freedom HL7 processor takes the notes associated with the edit reason and automatically inserts them in the Notes field of the document. This allows edit team staff to work a document without ever having to look up the notes in the billing system. A missing diagnosis code, for example, is sent to the Missing Diagnosis queue, and the relevant codes and notes are imported into the Notes field of the document. Once an edit team member satisfies the edits, they send it back to the holding queue, where the document awaits an additional HL7 file with a final billing flag. Once this flag is received, the requisition is moved to Workflow Complete, and thus the end of the process.

The automation of the workflow process has improved productivity on a variety of fronts. Enzo staff across the company (lab, billing, customer service) has immediate access to requisitions, and managers have real time access to monitoring tools for quality assurance and reports. FreeWf works in harmony with the information of the lab and billing systems, creating the most automated synergy attainable. This means maximum profit while working at maximum efficiency.

The power of the RICAR suite of products extends further than just laboratory requisitions. In addition to requisitions, Enzo has also chosen to implement a digital workflow for Explanation of Benefits.

Freedom is pleased to partner with Enzo Clinical Labs to create viable content management and workflow solutions across the entire organization.


Welcome to Enzo Clinical Labs, a full service clinical reference laboratory. We are one of the leading regional labs in the country, as we combine the extensive testing capabilities of a large laboratory with the convenience and personalized service of a local one. Enzo was one of the area's first laboratories to be awarded the prestigious College of American Pathologists (CAP) accreditation. This award indicates that Enzo has passed an extremely rigorous series of inspections far more sophisticated than those mandated by licensing authorities.

Our technical staff is led by board-certified pathologists and technical managers who combine many years of clinical experience with the desire to produce the highest quality laboratory results. Enzo's Quality Control program (QCP) was developed by clinical experts, and is among the most comprehensive in the industry. Our facilities are equipped with a state-of-the-art computer and communications system to allow rapid transmission of results to client physicians. In addition, Enzo maintains a broad menu of routine and esoteric clinical assays utilizing the latest in laboratory technology.

For more information, please visit www.enzo.com.


Freedom Imaging Systems has been a pioneer in the field of document management since 1995. Evolving with the dynamic industry of enterprise content management, Freedom offers small and large businesses alike the tools they need to streamline their business processes. Freedom provides everything a business needs to collect, capture, store and manage data of any kind. In 1995, Freedom created the first version of RICAR (Record Image Capture And Retrieval), their breakthrough document management solution.

RICAR is fully scalable and is easily modified to fit the needs of any type of business. RICAR processes and manages documents ranging from employment applications to explanation of benefits records, for customers ranging from car dealerships to clinical laboratories. RICAR is a software system that can be utilized among many fields and across every department. RICAR also provides users with a complete audit trail making regulatory compliance effortless.

For additional information please contact:
Freedom Imaging Systems
Phone: 734-327-5600
Freedom Contact page

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