XiFin Portals Improve the Client and Patient Experience While Helping Laboratories Manage Cost

Historically, when a patient received an Explanation of Benefits (EOB) and an associated bill for laboratory diagnostic services, and the patient had any questions about the charge(s), they had to call into the laboratory to get those questions answered. They also needed to call into the laboratory to ask to set up a payment plan, if they could not afford to pay their balance in full. In some cases, patients even had to call the laboratory to pay their balance by credit card.

For larger laboratories, this could mean hundreds of calls a day, which means laboratories would have to plan and staff accordingly to resolve these inquiries. These calls create an extra step for the patient and an extra expense for the laboratory. Also, if the patient feels they did not receive high-quality service from the laboratory, they may complain to their provider, which can cause friction between the provider and the lab.

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

Patient Portal

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

• View their statement
• Make credit card payments
• Set up payment plans
• Establish paperless billing

Setting up payment plans is becoming increasingly necessary as patient responsibility amounts increase, due to high-deductible insurance plans and lower payor reimbursements for certain diagnostic services. The old way to set up a payment plan involved the patient calling the laboratory customer service team, negotiating a mutually acceptable payment plan, and setting up a recurring ACH payment until the balance was paid in full. This required extra work for both the patient and the lab.

Through the XiFin Patient Portal, each laboratory enters their unique rules and parameters for payment plans, such as minimum amount eligible for a payment plan, number of payments allowed by range of balances, etc. The patients would then log into the portal to set up their payment plan, including the payment vehicle to be charged. This is an easy, cost-effective, and secure method for patients to set up their payment plans without the ongoing involvement of laboratory staff.

For smaller labs, the cost to print and mail statements can add up quickly. By providing patients the option to set up paperless billing appeals to many patients and can be an important cost-saving. Providing alternatives to traditional customer service calls is particularly valuable for the younger generation of patients who are used to being able to self-serve online. Matching their communication preferences improves the patient experience and controls costs for the lab.

Client Portal

The Client Portal helps laboratories more deeply integrate communication and data exchange with ordering physicians. This increases physician satisfaction and reduces errors. 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

In the same way that younger patients prefer not to have to make a call in to a laboratory to get a question addressed, likewise physicians typically lack the time to do so. Being able to correct missing information and work errors online, improves physician satisfaction, reduced errors, speeds reimbursement, and provides cost savings.

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 turn around time were measured for orders with missing or incorrect information.

Results

Turn-around time to receive corrected or missing information from physician offices was reduced from 60 days to 20 days.

Patient Service Center

The Patient Service Center helps the diagnostic laboratory get paid what is due from the patient more quickly and more cost effectively. For example, it lets labs check test information and patient eligibility upfront. It also provides a sophisticated patient responsibility estimator. Most other patient responsibility estimators on the market today use only a portion of the data required to accurately calculate the forecast of patient responsibility. XiFin RPM has all of the data required, and as such, creates a much more precise patient responsibility estimate.

The Patient Service Center provides an easy-to-use screen to enter the patient’s demographic and insurance information. The patient responsibility estimator then takes into account any relevant provider-specific pricing information, as well as the test of procedure information. The data leveraged by the XiFin patient responsibility estimator includes the expected reimbursement at the CPT code level, by payor plan, along with real-time eligibility information. The system then marries this data with the real-time eligibility transaction from the payor 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. Getting payment due upfront is much more cost effective than chasing past due balances after the fact.

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.

The XiFin portals help laboratories better integrate their relationships with ordering physicians and patients alike. The portals streamline many processes that used to require manual intervention at the physician’s office or the lab. As a result, diagnostic providers get paid more quickly, from payors and from patients. In addition to accelerating reimbursement, both physicians and labs benefit from cost savings. Finally, laboratories have an easy, effective way to improve their relationships with ordering physicians and patients.

See how diagnostics innovators Ambry Genetics, BioReference, and Pathnostics are leveraging XiFin capabilities to transform their patient and physician experience and improve their bottom line.

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