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XIFIN Billing Solutions

Flexibly Outsource All or Part of Your RCM Process in as Little as 30 Days

With XIFIN, you choose whether the best option for your organization is outsourcing your RCM operations, conducting these activities in-house with your own staff, or a custom combination of these two approaches. Plus, as your business needs change, you can easily transition between the models.

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XIFIN Outsourced Billing Services

XIFIN has more than 20 years’ experience partnering with hospital outreach programs, health system ambulatory services, imaging centers, independent laboratories, medical device organizations, pathology practices, and specialty physician groups to optimize billing and claim processing.

We offer unrivaled flexibility to meet your needs, whether you manage the billing yourself, outsource to our internal operations, or need a hybrid of both. Our unique model can help design a solution that fits today while providing the flexibility to adapt to your changing needs.

XIFIN Outsourced Billing Services ensure that you have complete visibility at all times. XIFIN clients can view the XIFIN RPM platform in real time, to see all claims that are being held for billing due to missing or incorrect information, rejections, denials, and appeals.

With XIFIN, there are no “black box” operations; our team and yours can monitor workflow and progress so that claims don’t fall through the cracks. Regardless of the billing option you choose, you can count on higher performance and increased revenue and profit.

XIFIN Solutions Recognized by Black Book Research
for Four Consecutive Years

Managing Medical Billing Yourself Is Not the Only Option


Achieving operational efficiency of financial operations for medical billing and revenue cycle management (RCM) is integral to success. Healthcare leaders know that by gaining efficiency through their billing and claim processing workflow and effectively managing their accounts receivables, they can improve cash collections and profitability. This is especially important as health systems, diagnostic providers, and specialty physician groups are operating at ever-tightening margins.

Finance and billing leaders can maintain control and visibility over financial operations, optimize revenue, and maximize cash collections, whether managing the process in-house or outsourcing all or part of their billing operations.

Outsourcing billing can play an essential role in four distinct situations

Sub-optimal Billing System


Hospitals, diagnostic providers, and specialty physician groups that suffer from inefficient manual processes, unnecessary write-offs, and bad debt due to antiquated or non-diagnostic specific billing software, or sub-optimal enterprise systems such as EMR or EHR systems

Rapid Expansion


Healthcare providers that are rapidly expanding - either organically or through an acquisition strategy — need a billing service that scalably supports rapid growth and complexity.

Core Business Focused


Novel diagnostic providers, whether esoteric, device, or IDTF certified, that are hyper-focused on product development and their core business functions benefit from having an RCM partner they can count on so that they don’t have to worry about their billing.

Resource Constrained


Specialty laboratories, health system ambulatory, or ancillary services with their own National Provider Identifier (NPI) that must share revenue cycle management resources have resource constraints or are challenged with finding regional expertise.

Cost Structure a Key Consideration

Performing RCM in-house means your cost structure is fixed (and predictable). However, when testing volumes precipitously drop or are inconsistent, a fixed cost becomes a liability. For that reason, some health systems, diagnostic and specialty providers are moving, or are considering moving, to an outsourcing model to create a variable cost structure that aligns with testing or device volume changes. As volume and business grow, their costs scale proportionally. When volumes decline, they have protection on the downside.

Struggling with Appeals?

XIFIN can work with you to create an appeals plan for both administrative-type appeals and more comprehensive appeals. For example, responses to experimental, investigational, or medical necessity denials can be handled with customized letters that are specific to the patient’s situation and how the physician utilized the diagnostic. They can include relevant documentation, such as letters of medical necessity.

XIFIN Outsourced Billing Services

File Maintenance


XIFIN manages the entry of new account, pricing, test, and device information, sets up payors within the XIFIN RPM solution, and keeps information up to date.

Customer Service


XIFIN Outsourced Billing Services provides customer service capabilities, including communications with ordering physicians to obtain or correct information, answering calls from patients regarding benefits or billing, customer complaint resolution, and management of customer feedback.

Claims Processing


Automated eligibility checks ensure that patient insurance information correlates with the provided date of service. If there is an error, the lab, group, or department can easily follow up, improving the likelihood of receiving accurate information. XIFIN Outsourced Billing Services takes care of claims submission, acknowledgment and reconciliation, and follow-up.

Exception Processing


XIFIN resolves errors by researching, obtaining, and updating patient demographic information and generating and responding to error-related correspondence. Error processing services include updating permanent patient demographics, remittance advice remark codes, and claims adjustment reason codes and processing clearinghouse rejects and returned mail.

Payment Posting


Payments from third parties, patients, and clients are posted automatically when there are no discrepancies, and files are balanced. XIFIN manages manual payment postings when required to address discrepancies, remit errors, and payor-specific adjustments.

Order Entry


XIFIN RPM interoperability with laboratory information systems and other systems of record allows patient demographic and billing information to enter into an optimized and automated workflow. XIFIN Outsourced Billing Services can also process requisitions received through non-automated means.

Why Choose XIFIN as Your Outsourcing Partner?

Expertise


The breadth and depth of XIFIN’s collective intelligence is unparalleled, covering the vast majority of payors, and a broad range of regional and national diagnostic testing and monitoring providers. The XIFIN outsourced billing team’s expertise minimizes the provider’s need to recruit and retain hard-to-find talent.

Payor Relations


With data on more than 3,000 payors and an enormous volume of processed claims, XIFIN’s payor relations team has unparalleled visibility into problematic payor changes or errors and the relationships to get them addressed.

Electronic Data Interchange (EDI)


XIFIN’s EDI team is responsible for securely moving relevant files between payors and clients, ensuring everything is tracked and correctly reconciled, and loading it back into the system at the line item level. XIFIN maintains multiple monitoring tools that enable identification of rejected files and denied claims, and also identify systemic issues that need resolution.

Technology


XIFIN RPM’s cloud-based infrastructure virtually removes healthcare organizations’ need to spend time and money on sophisticated hardware and software environments. XIFIN is a true software-as-a-service (SaaS) provider with a robust platform designed for interoperability and scalability, allowing the XIFIN outsource billing team to maximize efficiencies, automation, and cash collections.

Compliance


The most effective prevention against fraud waste and abuse is separating the billing and the coding. Healthcare organizations can further reduce their compliance concerns by outsourcing their revenue cycle management to an RCM partner like XIFIN that has a best-in-class compliance program.

XIFIN RPM: The right choice with the flexibility to change


Traditional billing systems lack the referential and financial integrity required to deliver accurate, auditable information. XIFIN RPM is an AI-enabled revenue cycle management platform that optimizes billing and accounts receivable processes, as well as financial reporting and management. It also automates workflow, facilitates claim and appeal filing, and reduces regulatory compliance risk.

XIFIN RPM delivers full visibility to understand the financial status of every claim at every stage, from order submission to payment. XIFIN RPM is the comprehensive, automated RCM solution you need to maximize efficiency, improve cash collection, and increase financial accuracy. Whether they use our outsource billing service or manage billing in-house, XIFIN clients gain access to the information and tools needed to ensure maximum reimbursement and strategically manage their businesses.