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Automated Insurance Discovery: Overcome Your Obstacles

August 1, 2018

One of the largest obstacles to laboratories getting paid for their services is a lack of accurate patient insurance and demographic data. Laboratories often receive ordering hospital and physician data prior to it being complete and correct. Complicating the situation even further for labs is the frequent lack of access to the patient before services are rendered. These obstacles directly impact laboratories’ bottom lines.

Traditionally, labs have tried to solve these data issues through additional labor. Unfortunately, having more people to call and chase missing data often causes more problems, including significant increases in operating costs, more frequent data entry errors, increased need for managerial oversight, and decreased patient and provider satisfaction. 

Human follow-up on inaccurate or missing patient data can have unexpected consequences: 

  • Decreased physician or client satisfaction due to having to field lab billing department information requests;
  • Confused patients stemming from times when a laboratory calls them directly to ask for information;
  • Cost-benefit tradeoffs, derived from unexpectedly high labor cost associated with obtaining the correct information;
  • Additional data entry errors due to manual entry, and discretionary (rather than procedural) decision-making.

So, what’s the fix? Automated Insurance Discovery. XiFin has incorporated additional automated insurance discovery capabilities to its existing eligibility checks, auto-match capabilities within the XiFin RPM 9 solution. These combined capabilities have proven to increase revenue by 5% on average. Our insurance discovery partner FrontRunnerHC reports that 49% of cases result in new address info, and 42% of cases result in billing coverage not previously found. XiFin RPM 9 automation ensures that eligibility checks, auto-match capabilities, and other front-end processes are executed in advance of triggering an automated insurance discovery workflow to enable the most cost-effective solution to resolve the patient data challenge.

Interested in exploring how automating your insurance discovery process might work for you? Register for our upcoming webinar or request a demo today.

 

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