Stopping Margin Erosion with Payer & Provider Analytics
This session dives deeper into stopping margin erosion by focusing on payers and referring providers. Attendees will learn how to monitor expected versus actual reimbursement, spot silent payer policy changes, and recover underpayments. We will explore how to evaluate provider performance using clean claim rates, denial trends, and payer mix analysis to identify unprofitable patterns. Leave with practical strategies to re-balance referral sources, strengthen payer negotiations, and protect outpatient revenue. Sponsored by: XiFin, Inc.
Key Takeaways
- Identify payer behavior changes by tracking expected versus actual reimbursement and quickly responding to silent policy shifts
- Analyze denial trends to uncover root causes and implement process fixes that reduce recurring payment delays
- Evaluate referring provider performance using metrics such as clean claim rates, denial percentages, and cost-to-collect
- Assess payer and test mix patterns to detect cherry-picking or volume skews that erode margins
- Develop corrective strategies to renegotiate contracts, rebalance referral sources, and improve overall profitability
Speakers
Stephanie Denham
VP, RCM Systems and Analytics
XiFin, Inc.
With 20+ years of experience in finance and revenue cycle management, Stephanie has expertise in RCM best practices and using data-driven insights to drive operational enhancement. As VP, RCM Systems and Analytics, Stephanie supports XiFin customers in system and process automation and analytics. She also facilitates cross-customer analysis on productivity metrics and utilization of system functionalities to help drive opportunities in product development and functionalized workflow. Prior to joining XiFin, Stephanie held a role as Director of Client Management at Change Healthcare.
Diana Richard
AVP, National Accounts, Pathology, Radiology and Healthcare Systems
XiFin, Inc.
Diana Richard brings over 20 years of diagnostic provider billing experience to her role as Associate Vice President of National Accounts at XiFin, Inc. Specializing in Pathology, Radiology, and Hospital Systems, she serves as a strategic support liaison for XiFin’s diagnostic clients. Diana’s expertise extends to Anatomic Pathology, where she excels as a subject matter expert. She conducts routine data studies on reimbursement trends, utilizing her analytical skills to provide valuable insights to clients. Beyond analysis, Diana is a proficient communicator, sharing findings through presentations, webinars, blogs, and conference posters. Her dedication to driving innovation and excellence in diagnostic provider billing cements her reputation as a respected leader in the field.
