First of its kind integrated solution will improve reimbursement, reduce denials, accelerate patient access to care and provide greater visibility into prior authorization process
SAN DIEGO, Calif., -- April 25, 2018 -- XIFIN, Inc., the healthcare information technology company revolutionizing the business of healthcare diagnostics, today announced a strategic partnership with PriorAuthNow to bring an integrated, automated and simplified prior authorization process to diagnostic laboratories for the first time. The integration of PriorAuthNow’s platform with XIFIN RPM 9’s intelligent automation will optimize the process for both hospital-based and independent labs handling test orders that require prior authorization. This partnership makes XIFIN RPM the only diagnostic laboratory revenue cycle management solution with an automated and integrated prior authorization solution to reduce denials, accelerate reimbursement, improve workflow, and make the overall process simple and transparent.
Traditionally, the prior authorization process has been disconnected and time-consuming, requiring high levels of manual work, such as phone calls to insurers and sifting through pages and pages of medical records – ultimately delaying patient care. In addition, next-generation sequencing and complex molecular diagnostic tests that require prior authorization are becoming more common, exacerbating the prior authorization challenge. Each year, $31 billion is spent on prior authorizations, and 40 percent of prior authorizations are abandoned due to complex approval policies. The combination of XIFIN RPM 9’s intelligent automation with PriorAuthNow’s platform will streamline this process and directly impact diagnostic laboratories’ bottom lines through improved reimbursements rates and decreased administrative labor costs for complex diagnostic tests.
“Both hospital-based and independent labs are seeing a steady increase in more complex test orders, such as genetic testing. They need a more efficient way to secure the required prior authorizations on these tests, allowing patients to obtain important diagnostic information in a timely manner while securing the appropriate reimbursement,” said Lâle White, CEO, XIFIN. “By partnering with PriorAuthNow, we’re addressing this shift in the healthcare market and giving labs, ordering physicians, patients and payors significant improvements into the prior authorization process, delivering notable clinical and financial value.”
A More Intelligent Process for Labs, Physicians, Payors and Patients
PriorAuthNow securely connects providers’ electronic health records systems (EHRs) with insurance carriers, removing the inefficiencies, complexity and fragmented experience of the current process. PriorAuthNow gives clients one place where all prior authorizations are submitted, monitored and completed, while XIFIN RPM 9 intelligently incorporates the prior authorization information needed for reimbursement at the right time.
This unique capability provides numerous benefits for labs, including:
• Improved reimbursements, fewer denials and less time spent on related administrative activities.
• Greater accuracy, less manual intervention and fewer errors due to intelligent automation.
• Better visibility and transparency that enables proactive performance management.
• More clarity around continual policy changes and payor requirements.
• Accelerated patient access to care leading to faster treatment—and a better overall experience.
“We traditionally see a 50% improvement in productivity by leveraging an automated and streamlined solution. This ‘found time’ means that healthcare team members can spend time on activities that more directly impact patient care and outcomes,” said Ryan Monnin, chief revenue officer at PriorAuthNow. “By integrating our platform with XIFIN RPM 9, we are marrying two powerful technologies to address a big reimbursement roadblock and providing prior authorization transparency not available today.”