Reduce the Burden, Cost, and Complexity of Prior Authorizations and Appeals

Reduce the Burden, Cost, and Complexity of Prior Authorizations and Appeals

Maximize Revenue and Profitability While Decreasing Labor Impacts through Automation and Artificial Intelligence

The impact on laboratories and remote patent monitoring organizations in relationship to prior authorization (PA) processing is immense. XIFIN regularly analyzes cross customer trends to alert clients and the industry about key findings. XIFIN’s collective intelligence has identified a 311% increase in prior authorization-related denials across all customers, including a 92% increase specific to proprietary testing and 52% for molecular testing.

Prior authorization increases have a very real impact on diagnostic provider’s labor requirements and profitability. For example, women’s health prior authorization-related denials have increased by 62% in the last 24 months, representing a cash impact of $98.72 per procedure to non-invasive prenatal testing providers. Remote patient monitoring organizations are not immune. Cardiovascular disease-related prior authorization denials have increased more than 54% in the same time frame.

XIFIN RPM is a machine learning-enabled revenue cycle management platform that optimizes billing and accounts receivable processes, as well as financial reporting and management. It also intelligently automates workflow, facilitates claim and appeal filing, and reduces regulatory compliance risk. XIFIN RPM is cloud-based and designed to integrate with strategic partners that specialize in core competencies that enhance the end to end revenue cycle process.  As a result, XIFIN can keep diagnostic providers at the forefront of change and deliver the best possible value.


Introducing our newest prior authorization partner, Infinx.

Get faster prior authorization approvals using automation and AI-driven technology plus specialists. Infinx blends automation, artificial intelligence, analytics, and certified specialists to give providers complete coverage for the prior authorization workflow from determination, initiation, to status follow-up/verification.

98%

Able to obtain a prior authorization 98% of the time

50%

50% increase in cost efficiency, reducing your staff’s administrative burdens and operating costs

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By using XIFIN RPM, you can:

  • Prevent front-end denials through configuration of your RCM workflow by payor, payor plan, and CPT code
  • Minimize and manage errors and back-end exception processing through intelligent workflow
  • Automate appeals workflow both for individual claims and batch processing
  • Leverage business intelligence reporting to gain insights regarding prior authorization impacts
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By using Infinx, you can:

  • Automate your prior authorization workflow, getting the data you need in real-time
  • Obtain full transparency into your prior authorization workflow using real-time analytics and robust status reporting to track every claim
  • Get prior authorizations for routine tests initiated within 24 hours, and high priority STAT cases initiated within 30 minutes
  • Integrate prior authorization automation processes bi-directionally with your laboratory information system or revenue cycle management solution
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About XIFIN

XIFIN is a healthcare information technology company that leverages diagnostic information to improve the quality and economics of healthcare. The company’s cloud-based technology facilitates connectivity and workflow automation for accessing and sharing clinical and financial diagnostic data, linking healthcare stakeholders in the delivery and reimbursement of care.

 

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