29th Annual Executive War College
XiFin at the Forefront of Innovation and Strategy at EWC
It was another groundbreaking year at the 29th Annual Executive War College (EWC)! We enjoyed the opportunity to connect with many industry leaders, exchanging insights and exploring the transformative forces shaping healthcare.
We hope you made the most out of your experience at EWC, and had the chance to attend sessions with XiFin experts, including CEO Lâle White, for important discussions around timely topics. If not, we encourage you to download our presentations by completing the form to the right so that you don’t miss out on the important information we shared. As a bonus, we’ve recently published a blog recapping key takeaways from EWC. Read it now.
Big Changes in Healthcare: New Regulations and New Diagnostics Players Poised to Reshape Lab Testing
Lâle White
Executive Chair and CEO
The diagnostics business is constantly changing. Every day, laboratories face new challenges, from payor requirements to powerful new players entering the market and increased regulatory and compliance considerations. While complex, these changes also create new opportunities.
Lâle provided information and her insights on the key issues and trends shaping our industry and what executives need to know and do to succeed in our complex and ever-changing landscape. Topics covered include:
- Legislative and regulatory trends, including the VALID Act, SALSA, and PAMA
- Potential impact of FDA’s bid for control of laboratory-developed tests (LDTs)
- Impact of consumer-directed healthcare shifts and patient experience expectations
- Competing with and aligning with the non-traditional players that are moving more aggressively into the healthcare and diagnostics market
- New interoperability requirements for a distributed healthcare delivery system
- Role of strategic advocacy to drive industry transformation
Panel: Timing and Implications of FDA LDT Rule; Reforms to CLIA Regulations; Wider Use of Z-Code by Payers
Lâle White
Executive Chair and CEO
William Morice, MD, PhD
President and CEO, Mayo Clinic Laboratories
Gabriel Bien-Willner, MD, PhD
Chief Medical Officer, Palmetto GBA
Tim Stenzel
CEO, Grey Haven, LLC
Lâle White joined panelists from Mayo, Palmetto, and Grey Haven, to discuss and debate the hottest topics of the day.
Latest Trends in Managing Denials and Appeals of Clinical Lab and Pathology Claims
Diana Richard
AVP, National Accounts, Pathology/Radiology/Health Systems
Stephanie Denham
AVP, RCM Systems and Analytics
Revenue cycle management (RCM) is increasing in complexity. Payors introduce new and more rigid policies that make collecting reimbursement for the services rendered much more challenging for all types of diagnostic providers.
Taking a strategic approach to RCM and having a flexible and agile process, supported by the right technology, has never been more valuable. In this session, our experts presented and discussed the 2023 denial and appeals trends based on data from XiFin customers. This educational session covered:
- How to enhance productivity and optimize the efficiency of your appeals process through automation, improving both the speed and propensity of reimbursement
- How to respond to top denial reasons by payor group to maximize appeal success
- The latest appeal success rate benchmarks and how to compare your organization’s performance
- Tricky payor policies to watch out for to minimize denials and improve appeals success
- Strategies to measure the ROI of your appeals process
This session also offered insights into the changing behavior of payors, the ways payors modify claim processing protocols that drive denials, and XiFin-recommended practices for an appeal process designed to help you automate key tasks that save time and improve appeal success.
How AI Is Reshaping Revenue Cycle Management
Jeff Carmichael
SVP Engineering and Analytics
Sandra Greefkes
VP, Product and Partner Marketing
Operating in an environment of ever-changing payor policies and behavior, finance and revenue cycle leaders must expand their understanding of how artificial intelligence (AI) can help them address operational and business issues, from an increase in denials to working errors more efficiently. In this session, Jeff Carmichael shared learnings from AI projects, the need for automation as a foundation before applying AI, and the benefits of a more robust approach to AI-enabled RCM. Jeff presented a comprehensive and strategic approach to data, automation, and AI that can help your organization:
- Remove friction throughout the patient’s experience.
- Route errors based on payment risk or billing team member expertise.
- Leverage AI to translate various payor responses into the most appropriate reason code and next actions.
Participants learned how various analytics and visualizations can help determine where to focus AI efforts and gain a deeper understanding of the practical applications of AI-enabled RCM workflow. Participants also discovered how AI can be applied to payor responses and the automation that can be garnered.
Panel: Developing and Enhancing Win/Win Relationships That Add Value to Key Payers and Health Plans in Your Region
Clarisa Blattner
Sr. Director of Revenue and Payer Optimizations
Karen McFadden
John Norkett
VP, Payor Solutions, LabCorp
Kathryn Stough
Principal, K-H-S Solutions, LLC
Clarisa Blattner joins panelists from LabCorp and K-H-S Solutions to discuss strategies for fostering mutually beneficial relationships with key payers and health plans to maximize value in your region.
Expanding Your Lab’s Market Access: Leveraging Existing Contracts to Increase Covered Testing Services, Gain Provider Status with New Payors, and Negotiate More Reimbursement
Heather Agostinelli
VP, Head of Specialty RCM
Clarisa Blattner
Sr. Director, Revenue and Payor Optimizations
Debbie Windsor
VP, Market Access
With ongoing revenue compression and complex payor policies, laboratories must optimize payor contracting and market access to maximize reimbursement. In this session, participants gained a greater understanding of why investing in market access is essential to solidifying payor coverage and how only through collaboration across market access, commercial/sales, and revenue cycle management (RCM) teams can diagnostic organizations overcome the hurdles of:
- Attaining and expanding payor coverage
- Achieving accurate medical coding
- Ensuring accurate, complete reimbursement
- Upholding billing compliance standards amidst changing payor policies and behavior
At XiFin, we’re committed to empowering labs and pathology groups with cutting-edge solutions designed to drive profitability, enhance patient care, and optimize operational efficiency. How can we help you? Let’s chat at Executive War College. Fill out the form to the right to schedule a meeting.
The Annual Executive War College Conference on Diagnostics, Clinical Laboratory, and Pathology Management is the world’s largest event focused exclusively on managing medical laboratories. The event gives you access to the thought leaders, experts, and analysts you need to develop the right strategies for your lab.