Transformative RCM Platform Features Robust Automation, Including Denials and Appeals Management, Enhanced Self-Service, and Advanced Analytics and AI Options
Today’s diagnostic laboratory leaders face more challenges than ever before – from increasing volumes to more rigorous payor requirements and changing PAMA reporting deadlines. To help lab leaders meet these demands, XIFIN introduced XIFIN RPM 11, a transformative revenue cycle management (RCM) platform that features a new level of robust automation, enhanced portals, and advanced analytic and artificial intelligence (AI) options that diagnostic providers can use to respond to increasing market demands, patient expectations and reimbursement challenges. The latest version of XIFIN’s flagship RCM platform optimizes cash collections, enables real-time connectivity and error correction, and provides enhanced self-service for patients and physicians.
Based on XIFIN analysis, approximately 35% of all diagnostic procedures have errors that need correction before they can be reimbursed (dirty claims), which translates to upwards of $20 billion per year in either delayed or permanently lost reimbursement in the U.S. alone. XIFIN RPM 11’s robust automation combats these losses by automatically identifying errors and cleaning – without human intervention – a significant percentage of dirty claims, resulting in reduced denials, and faster and higher reimbursement rates.
Superior Automation and Artificial Intelligence Optimize Revenue
Capitalizing on XIFIN’s unmatched industry intelligence and more than 20 years’ experience with claims data, XIFIN RPM 11 is an AI-enabled RCM platform with workflow automation and advanced analytics. Artificial intelligence applied to revenue cycle data uncovers actionable insight that can influence workflow configuration decisions based on real-world payor behavior. AI also supports more timely discovery of changes in payor behavior and facilitates faster operational adjustments to mitigate impact. Historically, claim processing has been focused on productivity, but evidence indicates workflow configuration based on task effectiveness is more impactful.
XIFIN RPM 11 features more robust workflow configuration at multiple levels, including facility, client, payor or payor plan. XIFIN RPM 11 enables greater efficiency for both individual and batch claims. Unlike other RCM systems that require manual efforts once the claims are denied, XIFIN RPM 11 reduces costs and delivers denials and appeals process automation, including automatic generation of payor-specific appeal forms and appeal letters.
“Improving clean claim rates has proven to be a real struggle for the industry, and continuing to use manual processes isn’t going to fix it. Technology, including AI, is the only way we’re going to solve the issue,” said Lâle White, CEO, XIFIN. “But these advanced techniques need high quality, clean data and enough of it to learn and improve. It’s critical that lab leaders capitalize on available technology and data science to gain better visibility into their business, understand what they need to respond to and optimize their process, and ultimately increase cash flow and reduce costs.”
Enhanced Patient & Physician Self-Service Improves Payment Collections
Increasing patient responsibility and evolving expectations are driving the need for diagnostic providers to offer expanded consumer-facing services and information. The new XIFIN RPM 11 features a patient portal that allows consumers to determine insurance eligibility and estimate out-of-pocket costs for greater cost transparency. XIFIN RPM 11 also allows labs to leverage expanded billing and payment collection options, including paper invoice suppression, patient notification letters and interactive statements. Additionally, it includes a physician portal to enable supporting documentation submission and enhanced information exchange.
Advanced Analytics and Visualization Provide Deeper Business Insights
XIFIN RPM 11 users can choose to extend the enterprise-grade business intelligence that comes standard with XIFIN RPM with new Advanced Analytics options that offer additional scalability, flexibility and speed. The AI capabilities paired with XIFIN Business Intelligence provide financial insights faster, greater long-term trend analysis and can pinpoint revenue cycle workflow efficacy opportunities.
“We are a highly focused data solutions company, so having a partner who understands the importance of strong, empirical data like XIFIN is a key to our success,” said Christopher Watts, Vice President of Revenue Cycle Management at Cordant Health Solutions. “XIFIN’s new business intelligence options provide us with more insight into the key drivers of our business, and the advanced analytic visualizations allows users to quickly and easily understand those insights with very little training or reporting experience. It’s clear that this is the next generation of analytics for revenue cycle management in the laboratory industry.”
Offering innovative tools for monitoring behavioral health, chronic pain and criminal justice cases, Cordant Health Solutions is one of the only healthcare companies that offers monitoring and risk assessment tools through its drug testing options and full-service, high-touch pharmacies, which specialize in the complex management and dispensing of controlled substances. The company selected XIFIN due to its many years of RCM experience, deep domain expertise and technological innovation.