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Blog Posts by Tag: Revenue Cycle Management

Optimizing Patient and Payor Payments with Patient Responsibility Estimator Tool

In 2021, the total US out-of-pocket healthcare patient spending increased by 10% from the previous year and is expected to continue to increase by 9.9% annually through 20231. An increase in a patient’s financial responsibility is a growing problem in healthcare and is driven by several factors including: Payors shifting a larger portion of the payment to patient responsibility, on average...

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The Importance of Connectivity and Automation to Accelerate Revenue Cycle Management: A Focus on Insurance Eligibility and Discovery

Kouri AndrewsDirector, EDI Operations, XIFIN Mike FauverAVP Health Systems, XIFIN Using disconnected systems to manage the complexity of medical claim billing and revenue cycle management (RCM) can lead to errors, inefficiencies, and rework. This drives delayed reimbursement and higher operating...

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Mitigating 2023 Proposed Medicare Reimbursement Cuts

Over the past few years, due to the public health emergency (PHE), Congress has stepped in to halt pending Medicare cuts. However, legislative intervention during the PHE only delayed the cuts until the following year. With the proposed 2023 Medicare Physician Fee Schedule released in July, which contained several reductions, and the return of the 2% sequestration, healthcare providers need to...

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Laboratory Test Claim Denials and Appeals Trends

I recently had the privilege of presenting an in-person workshop in conjunction with The Dark Report Executive War College on Laboratory and Pathology Management. The workshop was on the topic of “Latest Trends and Denials Involving Lab Test Claims.” In this session, I shared XIFIN insights into payor behavior changes and shifting claims processing protocols and highlighted the importance of a...

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How Real-Time Connectivity Can Drive Revenue, Reduce Cost, and Increase Client Satisfaction

In today’s healthcare environment, there is a lot of uncertainty about what revenue will look like in the face of declining reimbursement, increasing payor denials, and staffing shortages. At the same time, there are greater expectations on the workforce to comply with regulations and payor reimbursement requirements, which can differ by payor and state. Therefore, it is essential for healthcare...

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Understand Black Book Research's Assessment Criteria for Evaluating RCM Services Providers on Measures Associated with Service

This blog is part of a series. Read Part 1 and Part 2. This is our third and final blog in this series about the advantages of leveraging Black Book Research’s comprehensive assessment criteria for evaluating outsourced revenue cycle management (RCM) service providers. In this blog, we focus on the measures associated with Service.Black Book Research evaluates outsourced diagnostic/laboratory RCM...

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Part 4: Analytics for Finance Leadership

This is the fourth installment of a four-part series. View Part 1 (How to Calibrate Hospital Lab Financial Performance), Part 2 (Analytics for the RCM Team), or Part 3 (Analytics for the Lab Director). Increased staffing costs and investment losses are impeding hospital profitability. Recent financial disclosures by large health systems including Kaiser Permanente, Providence Healthcare, and Mayo...

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The Value of True Customer Advocacy

XIFIN Complaint to CMS Results in Modified Guidance on Health Plans’ Payment of Claims Customer advocacy is a core tenet of our business at XIFIN. While it’s easy for companies to say that customer-centricity and advocacy are core values, the proof is whether customers experience the value and impact of said commitment. The following article, reprinted from the XIFIN XiConnect Customer Newsletter...

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