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XIFIN Revenue Cycle Management Platform

Artificial Intelligence and Cloud-based Technology for Maximum Impact

The information held within laboratory, medical device, and radiology, information and billing systems is incredibly useful and powerful. The XIFIN Revenue Performance Management (RPM) web-native platform links the many different stakeholders and exchanges to the right data at the right place at the right time.

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XIFIN RPM Platform: Real-Time Connectivity

The information held within laboratory, medical devices, and radiology information and billing systems is incredibly useful and powerful. The XIFIN Revenue Performance Management (RPM) web-native platform links the many different stakeholders and exchanges to the right data at the right place at the right time.

Leveraging the XIFIN technology foundation which includes engines, portals, web services, document storage, and real-time connectivity allows diagnostic and medical providers to extend their reach for maximum impact. Artificial intelligence (AI) gives service providers of all specialties the ability to use data to take the guesswork out of revenue cycle management and make it easier to optimize processes and decisions.


XIFIN provides the connectivity required for today's complex revenue cycle management environment

 

 

 

Spotlight on How Portals Drive Revenue, Reduce Cost, and Engage Patients and Clients

There are many reasons why patients may need to call into a diagnostic or medical provider after a visit or monitoring event. Questions about bills, paying account balances, or requesting payment options can add up to hundreds of calls a day. Billing and customer support leaders must forecast, plan, recruit, and staff accordingly to ensure that these call centers are appropriately resourced.

Additionally, these calls create extra steps for the patient and additional expenses for the diagnostic provider. Also, if patients feel they did not receive high-quality service from the diagnostic or medical group they may complain to their provider, which can cause friction between the physician's office and the specialty provider.

To address these issues, XIFIN developed three separate portals ― one for patients, one for ordering physicians, and one for diagnostic or specialty medical providers — each designed to address specific customer service-related tasks. Together these portals enable diagnostic and specialty providers to get paid as quickly as possible, with fewer resources. Likewise, by improving efficiency and effectiveness, the portals allow diagnostic companies, laboratories, pathology practices, or specialty physician group to grow without needing to increase their staffing at the same rate.

Client Portal

The Client Portal helps diagnostic providers and specialty physician groups more deeply integrate communication and data exchange with ordering physicians. Physicians and their teams are challenged by following up with specialty groups and labs via phone calls during specific office hours. Being able to correct missing information and work errors online when it suits the physician office’s schedule improves satisfaction, reduces errors, speeds reimbursement, and provides cost savings.

Through the Client Portal, physicians and their staff can more effectively:

  • Perform order entry
  • Access clinical decision support
  • Examine statements at the line-item level
  • View test information and pricing
  • Correct billing errors upfront to expedite reimbursement
  • Provide patients with an estimate of their out-of-pocket costs
Download Data sheet

Patient Portal

The cost to print and mail statements adds up quickly. The option to set up paperless billing appeals to many patients and can be an essential cost-saving initiative. Providing the ability to set up payment plans is becoming increasingly necessary as patient responsibility amounts increase. But this can be a costly endeavor if it requires patients to call to set it up.

Through the XIFIN Patient Portal, laboratories, pathology practices, medical device and digital or telehealth companies can enter their unique rules and parameters for payment plans, such as minimum amount eligible for a payment plan, the number of payments allowed by range of balances, etc.

Download Data sheet

The XIFIN Patient Portal enables patients to securely log in, anytime, to:

  • View their statement
  • Make credit card payments
  • Set up payment plans
  • Establish paperless billing
  • View patient responsibility estimate
  • View test results

This is an easy, cost-effective, and secure method to serve patients without the ongoing involvement of diagnostic provider staff. Providing alternatives to traditional customer service calls is particularly valuable for the younger generation of patients who are used to self-service online. Matching their communication preferences improves the patient experience and controls costs.


Client Portal Success

A recent case study demonstrated positive financial outcomes and highlighted a potential redirection of resources to more complex activities.

Over a 10-month period, there was a concerted effort to drive adoption and use of the client portal by ordering physicians and their teams, which resulted in a 65% increase in use. Then, cash collections and turnaround time were measured for orders with missing or incorrect information.

Results

$3M


Collected by 30 billing team members that performed the same function as the Client Portal in the same time period

$3.2M


Collected using Client Portal to obtain missing or incorrect information with no billing staff involved


Patient Service Center

The Patient Service Center helps the diagnostic or cross-specialty providers get paid what is due from the patient more quickly. It features an easy-to-use screen to enter the patient’s demographic and insurance information, lets diagnostic providers check test information and patient eligibility up front, and provides a precise patient responsibility estimator.

The patient responsibility estimator takes into account any relevant provider-specific pricing information, test or procedure information, and real-time eligibility in order to determine the patient responsibility amount. This enables the calculation of an accurate estimate of what should be collected from the patient at the time of service or at the time of order.

The Patient Service Center also displays the details behind the patient responsibility estimate, including any co-pay, co-insurance, deductible, and remaining deductible at the procedure level. This is essentially the data that a patient typically sees on an explanation of benefits statement, only it’s presented much earlier in the process, preventing an alarming surprise to the patient weeks after the test or procedure is completed.

XIFIN RPM Workflow Automation

Built to automate as much of the patient-to-cash process as possible, XIFIN RPM Engines are specifically designed to handle exceptions, help reduce manual work, and eliminate clerical decision making that can lead to compliance issues.

XIFIN RPM Engines are the brains behind the automation.

AI-enabled RCM and Analytics Solutions

XIFIN RPM is a comprehensive accounts receivable and financial management solution. It transforms the way you manage your organization’s revenue by using AI and analytics to address the problems that undermine the effectiveness and efficiency of your revenue cycle management (RCM) process.

XIFIN’s AI-enabled analytics solutions uncover insights that can inform both medical billing workflows as well as business forecasts. They are designed to enhance the business intelligence capabilities that come standard with XIFIN RPM.

AI and advanced analytics options include specialized data models, consultative or topic-specific visual analytics, and AI capabilities that can spotlight profitability, reimbursement, and efficacy opportunities.

Insights could suggest changes to workflow configuration that prioritize effectiveness, not just productivity. Financial forecasting can improve with the ability to determine reimbursement likelihood on near-term outstanding accounts receivable.

"XIFIN differentiates its RCM through a robust set of capabilities that include data integrity, machine learning, client and patient engagement tools, next-generation business analytics and data visualization options, automated billing and accounts receivable workflows, a web-native platform, HIPAA-compliant environment, interoperability with most external vendor systems and supported by a full set of managed services."

Mutaz O. Shegewi
Research Director, Provider IT Transformation Strategies IDC Health Insights

XIFIN RPM Advanced Analytics
Actionable Insights is Transformative

This eBook describes the operational and financial analytics available through Tableau driven workbooks specifically designed for consumption by C-level executives, finance, billing and revenue cycle leaders, and departmental managers.

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Web Services

End-to-end connectivity from patient to payor with clean, audience-centric access.

XIFIN Web Services provide two-way real-time data exchange enabling “digital conversations” between client and patient portals, IVRs, LIS, CPOE, EMRs, and other systems. Using XIFIN Web Services to integrate with the following systems delivers significant benefits to diagnostic providers, their clients, and their patients.

Integration with

Physician’s Office Systems


Results in fewer calls to the diagnostic provider to obtain information-related to services and pricing and faster response time leading to increased client satisfaction.

Back-office Provider Information Systems


Ensures no duplicate order entry and fewer errors.

Front-office Information Systems


Minimizes front-end rejections and eliminates most manual reconciliation of electronic payments or cash to XIFIN RPM.

Portals or IVR Systems


Accelerates receipt of payments, provides 24/7 payment acceptance and processing, and frees up billing staff for more complex and valuable activities.

Standard XIFIN RPM Web Services address a host of needs

Information group What does this information group address?
Encounter /Accession/Visit
  • Search for accessions/encounters/visits in XIFIN RPM.
  • Validate errors before an accession is created.
  • Create and update accession/encounter/visit information.
  • Retrieve all information on an accession/encounter/visit including patient demographics, insurance, payments, and adjustments. 
Patient
  • Search for patient demographic records in XIFIN RPM.
  • Create and update demographic and insurance information associated with a patient record.
  • Retrieve updates/changes made to a patient record in the billing system for use by integrated systems.
Client
  • Search for a client in XIFIN RPM.
  • Create new client records in the XIFIN RPM system from an interfaced system using the create client or copy client service.
  • Retrieve all demographic and pricing data associated with a client.
  • Retrieve client invoices in a PDF or Excel format (if configured) that include the current month to date invoice or all previous client invoices.
  • Obtain the client's current balance and the balance amount owing at 30 days, 60 days, 90 days, and over 120 days.
  • Retrieve the list of all payments and adjustments posted to a client account.
  • Post a new credit card or ACH payment against outstanding invoices. 
  • Provide the ability to determine the client or non-client price of tests within XIFIN RPM.
  • Create and retrieve all contact notes associated with a client account.
  • Review and update missing or invalid information associated with an accession/encounter/visit that cannot be bille, that was submitted by a client. 
  • Update census information associated with nursing home transactions. 
Payor
  • Search for and find details about a payor in XIFIN RPM.
  • Provide field-level edit information for a specific payor.
  • Verify whether the value of a required field is valid (acceptable) for the payor in XIFIN RPM.
Eligibility
  • Check patient insurance eligibility and display response in multiple formats to be consumed by an integrated system.
  • Provide all information retured by the third party payor, which will include co-pay and deductible information.
  • Determine the list of payors that allow eligibility to be performed.
File Maintenance
  • Search for and find details about tests in XIFIN RPM.
  • Create and update tests within the XIFIN RPM system.
  • Retrieve all information associated with a test, such as test description, CPT code, and where a test can be performed.
  • Create and update the performing facility in the XIFIN RPM system. 
  • Create and update Fee Schedules and pricing information in XIFIN RPM.
  • Create and update Special Pricing tables and assign them to a client account pricing record.
  • Add a document to the Doc Store system and link the document to an accession.
  • Allows an interface system to request the contents of any drop-down field in the service being called.
  • Update and retrieve cross-reference values in the XIFIN RPM for fields such as the Client, Facility, and Payor. 
Electronic Payments
  • Allows payments posted on a client or patient invoice and have the XIFIN RPM system reduce the AR.
  • Provide confirmation of a successful payment along with a confirmation ID from the credit card processor.
Patient Estimation
  • Do an insurance eligibility call and determine the patient co-pay and deductible based on the work ordered and insurance reimbursement.

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