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XIFIN Automation

Maximize Clean Claims. Significantly Reduce Denials. Automate Appeals Process.

XIFIN automation helps you ensure faster clean claims submissions and reduces labor costs, especially costs related to the appeals process. XIFIN automation also helps increase cash collections by reducing clerical errors and other issues that delay reimbursements or result in partial payments.

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"NHL chose XIFIN RPM for its automation, which is designed to reduce staff requirements and provide the flexibility of remote hosting. There were marked improvements over the first year in lab RCM outcomes after implementing XIFIN, namely in Days Sales Outstanding and receivables management."

Richard Tesoriero
Vice President Laboratories, Northwell Health Labs

The Importance of Automation

In today’s marketplace, laboratories, diagnostic providers, hospitals, and specialty physician groups face daily challenges to maximize collections from payors. Recent fee schedule changes have caused significant reductions in reimbursements for many organizations. Also, changes in payor policies create added pressure on cash collections and profitability.

To succeed, organizations need technology solutions that maximize automation. Incorporating new and useful automation capabilities into the revenue cycle management (RCM) process helps labs maximize revenue, reimbursements, and efficiency. -XIFIN has demonstrated that laboratories leveraging RCM automation improve clean claim rates, which results in improved cash collections and profitability.

XIFIN RPM Automation Capabilities

XIFIN RPM is the comprehensive RCM solution that optimizes billing and accounts receivable processes and maximizes reimbursements by automating billing workflow and expediting the filing of clean and accurate claims. For example, missing information and errors can be identified and fixed before claim submission, resulting in fewer denials or rejections.

XIFIN Provides the Essential RCM Automation Capabilities, Including:

Workflow Automation


XIFIN RPM maximizes operational efficiency through the automation of RCM workflows. This dramatically increases the submission of clean claims upfront. The small subset of exceptions is then addressed in a timelier, more efficient manner, ensuring maximum reimbursements.

XIFIN RPM workflow automation also minimizes manual processes and one-off decision making that can lead to errors resulting in unpaid, partially paid, or rejected claims.

Document Storage and Management


With XIFIN, documents can be securely uploaded to streamline workflows and improve efficiency. Documentation can be uploaded and attached to claims and appeals easily, allowing laboratories to generate bulk appeals that include all supporting documentation quickly.

This improves the efficiency of appeals and claim attachments by up to 300% and significantly reduces the expense burden of the appeals process.

Patient and Physician Engagement


Provide 24-hour, convenient access to lab results, statements, and bill payment capabilities. Payments are automatically applied in real-time to the account, which increases customer satisfaction and reduces errors. The XIFIN Portals also provide online access for patients and ordering physicians’ offices to securely interact with the lab to view pricing, fix errors, and upload documents in real-time.

Interactive Voice Response (IVR)


Interactive IVR supports incoming calls, outgoing calls, and text messages. Outbound IVR can be used with an aged receivables file to call patients when and where they are most likely to be reached. Patients can also use the IVR to make credit card payments and transmit other information to help them to resolve their accounts more quickly.

Eligibility Verification


Automated eligibility checks ensure that patient insurance information correlates with the provided Date of Service. If there is an error, the lab can easily follow up, improving the likelihood of receiving accurate information.

Claim Status


Users can send electronic claims status inquiries for eligible payors. Each claim status response received back from a payor is automatically uploaded into the system to provide valuable information about the adjudication of the claim.

Payor Edits


Payor edit automation helps ensure that claims meet payor requirements before submission. XIFIN manages regular updates of published payor edits, so the system is always up to date.

Prepayments


Support a better patient experience by calculating the expected patient responsibility and enabling prepayment. XIFIN Portals allow providers to determine the estimated patient responsibility and patients to make electronic payments at the time of order ― before a test is performed.