Five Reasons Why Paper Forms Cost More Than You Realize

POSTED November 30, 2022

Studies show that more than 50% of all lab tests are still processed on paper. While health systems and large national laboratories typically use software that enables the electronic transfer of lab orders and results, small to mid-sized labs still overwhelmingly rely on paper and fax machines, with the assumption that automation is too expensive. But do they know the actual cost of all that paper?

By combining the power of Shadowbox and Wave HDC, small and mid-sized labs (along with large labs) can provide their clinician customers with an electronic ordering experience that is fast, accurate, and secure at a fraction of the cost of traditional solutions. Before getting into how these two technologies solve the age-old paper problem, it’s important to understand just how costly all that paper is for labs and their clinician customers. Below, Shadowbox shines a light on the massive operational costs associated with paper that labs may be overlooking.

The Hidden Cost of Paper

  • Supplies & Logistics: Paper is expensive, and the costs for forms and paper-related processes are higher than labs realize. Labs can now eliminate the cost of paper, printing, shipping, and storage. EACH paper order currently costs between $5.00-7.50:
    • Branded form design, shipping, and subsequent mailings to clinics and sales reps
    • Revisions, reprints, and trunk stock for sales reps
    • Overstocking clinics with forms that are never used
    • Excessive courier fees for orders never made
    • Storage of completed paper requisition forms due to HIPAA requirements

  • Data Entry: Someone must enter the data from all those forms! Labs save time and money by doing away with error-prone, manual data entry. Data entry related to each form received at the lab costs between $2.50-3.75:
    • Keystroke errors and missing information can often lead to a costly effort to chase information to complete a claim
    • Paper forms may be illegible, soiled, ripped, or lacking required information
    • In a study comparing 228 manually entered lab requests to automated ones, 25% were incomplete, and more than 55% were considered difficult to understand or read.

  • Staffing Challenges: Onboarding and retaining entry-level staff is challenging with constant turnover and wage inflation. Staffing challenges add an additional $2.50 – 3.75 per form.
    • Data entry and medical billing personnel are difficult to staff and prone to high turnover
    • These jobs are labor-intensive, repetitive, and prone to manual data-entry errors
    • A data entry person can enter up to 30 forms an hour at an estimated cost of $15/hour, costing $0.50 per order
    • Medical billing specialists ensure claim submission and rework denied claims at an estimated cost of $21.00/hour.
  • More Denials: Payors continue to deny a significant number of claims. Each incomplete claim triggers a denial and appeal loop. Labs can reduce insurance denials and appeals and stop chasing payors by getting good and complete information at the time of order. Each incomplete/inaccurate claim costs between $12.50 - 15.00:
    • Incorrect and incomplete orders automatically trigger an insurance denial, with studies showing that as many as 61% of denied claims are initially denied for this reason
    • The administrative burden associated with running down missing information and filing claim appeals is high
    • The cost to appeal a denial is as high as $40 per claim, with paper claim denials at 35%

  • Increased Bad Debt: Unpaid and denied claims lead to high bad debt write-offs. Write-offs can range from $2.00 to $2,000+ per order.
    • Clinician clients may be unwilling or unable to provide missing information, provide necessary documents, and/or descriptions regarding medical necessity
    • The appeal window closes after a specific time frame

A Better Solution: Collaboration and Curation

Shadowbox and the Wave HDC data curation solution (known as the Wave Analyzer) work together to eliminate paper forms. Through the automated transfer of patient data sourced from the EHR to a customer-branded Shadowbox electronic lab order form, the Wave Analyzer performs real-time analysis of the EHR data. If the data is incomplete or inaccurate, Wave supplements the order with the most up-to-date insurance information.

The Wave Analyzer automatically verifies and corrects eligibility and demographic data, replacing missing or terminated coverage with the patient’s current coverage. The system contains over 400 million records and dynamically evaluates 108 data points. By populating the correct information at the time of order, before lab services are provided, the need for staff to manually review and manipulate the data is eliminated, creating an efficient and fully touchless pre-accessioning process.

Shadowbox and Wave HDC technology are redefining what it means to provide electronic orders and results. We’re changing the outlook on revenue cycle management for labs by dispelling the myth that automation is too expensive. By working together, we’re making it affordable and accessible. Our combined approach enables even the smallest of start-up labs (as well as the big conglomerates) to eliminate paper orders and manual tasks wherever possible and realize a proven 10X+ return on that investment.

We invite you to review our latest case study for more insights into the tremendous cost-saving benefits of the Shadowbox + Wave solution!

About Shadowbox

Shadowbox is a ground-breaking, patented automation platform built for healthcare. Our platform delivers instant integration and automation across the healthcare ecosystem by powering a browser with security, AI, and user-driven cross-application connections. Visit for more information.

About Wave HDC

Wave HDC is the industry leader in Healthcare Data Curation® services that translate into cost savings and operational efficiencies for laboratories, healthcare providers, and billing companies. The Wave HDC solution suite is the answer to lost revenue and revenue cycle management challenges due to rejected and uncompensated claims. To learn more about Wave HDC, visit

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