Essential RCM Capabilities for Streamlining Client Billing

Client billing, also known as account or physician billing, is a billing model that has been around for years in the healthcare industry. Client billing occurs when a provider bills a client, such as an ordering physician or another diagnostic provider, rather than a patient directly, or the patient’s insurance.

Although client billing can represent a significant portion of a provider’s revenue, it is often managed via labor-intensive manual processes. If the fee schedules, terms and special discounts are complex, the risk of errors increases dramatically, leading to payment delays and physician dissatisfaction. Additionally, if client billing is not integrated with insurance billing and revenue cycle management processes, manual changes in payment responsibility can cause errors. This lack of integration can lead to inefficiencies, accuracy issues, and compliance challenges, making it difficult for providers to monitor the timely payment of invoices.

Client billing processes need to evolve to meet the expectations of providers who now demand features such as paperless billing, the ability to view or pay multiple statements at once, and electronic payment options. Offering these advanced client billing features to providers can boost physician satisfaction, enhance collections, and improve overall staff efficiency.

The following are just a few capabilities the XiFin RPM platform offers customers to help manage client billing effectively.

1. Customizable Client Pricing

Client billing pricing can differ based on the client and procedure. Therefore, it is important to be able to configure multiple fee schedules, special price tables, and across-the-board discounts as needed. For example, in the XiFin system when configuring pricing for client billing, customers can establish an unlimited number of fee schedules and assign multiple schedules as well as a special price table to a client in a hierarchical fashion. An RCM solution designed with this level of configurability gives diagnostic providers tremendous flexibility in establishing client pricing and billing.

2. Flexible Invoice Configurability

Flexibility regarding the information displayed on the client bill, the frequency invoices are sent, and how invoices are sorted is also important.

XiFin RPM allows customers to work with their clients, such as referring physicians or other diagnostic providers, to configure what appears on their invoice, selecting from various attributes that can be displayed or hidden on the client invoice. For example, if the client’s accounts payable department does not want any patient identifying information, such as a patient name, to appear on their invoice, this information can be suppressed. With XiFin, it is easy to turn attributes on or off and thus customize what data appears on the invoice. This can be done across all clients and on a client-by-client basis.

Another example of this flexibility is the configuration of how client bill invoices are sorted, as well as how often bills are issued. If one client wants its invoices sorted by patient and to be billed weekly, and another client wants its invoices sorted by date of service (DOS) and delivered every other week, and a third client wants its invoices billed monthly and sorted using a combination of attributes, this is easy to set up on a client-by-client basis with XiFin RPM.

Another example of how XiFin RPM provides flexibility in invoicing relates to the ability to use sub-client or secondary IDs. In a hospital outreach laboratory, for example, there may be many different departments in the hospital that are ordering lab tests. Each department can be assigned a sub-client ID, to make it easier to track which orders are coming from which department. Each sub-client ID can then be subtotaled on the invoice and reports can be run at the individual sub-client level.

Client bills are generated as PDFs; however, they can also be configured as Excel spreadsheets if a client prefers to receive its invoices in that format. For clients who request an Excel spreadsheet format for their invoices, both the Excel spreadsheet and the PDF will be generated and available in the Client Portal.

3. Integrated Reporting and Billing

Running a client-level report in XiFin RPM allows customers to easily track profitability by client. Customers can see all of a client’s orders, what was billed to third-party payors, and what was billed to the client. Some other RCM solution providers have a more siloed approach to client billing. XiFin RPM is fully integrated, making reporting much cleaner. All of a client’s accounts receivable (AR) can be seen in a single view regardless of how it’s billed.

XiFin RPM also makes it easy to modify an accession to move from billing a third-party payor to billing a client and vice versa. For example, if a customer gets contacted by a billing clerk at a client who states that the patient’s payor information was sent over when, in fact, the client should be billed, it’s a simple payor id change in XiFin RPM. The system will then back out the third-party payor information and rebill it to the client at the correct client-specific rate. The change will also be reflected automatically in the month-end financial reporting from XiFin RPM.

4. Customizable Dunning Messages

In XiFin RPM, customers can customize the collection or dunning message at the client level based on the delinquency of the client invoice. For example, if a payment is less than 30 days past due, a short reminder message can be used in the invoice statement. Once a payment is 60 or 90 days late, that message can and should be more assertive.

5. XiFin Client Portal

The XiFin RPM Client Portal allows ordering clients, physicians, and their staff to interact with their client invoices online at any time and includes the following capabilities:

• Invoice Notifications – Within the portal customers can configure email alerts to notify clients when new invoices are available.
• View Balance – Clients can see balances and drill down into past invoices. Once client users logs in, they will see any invoices with outstanding balances and all previous invoices. The default setting in the Client Portal is to display the last 12 months of invoices, but the client can set it up to see more if preferred.
• Review Charges – In the Client Portal, clients can also see their current charges since their last invoice, even if they have not yet been billed. This allows clients to track charges and even make necessary corrections before receiving an invoice.
• Make Payments – Clients can also make payments on the portal. Payments can be made by credit card, debit card, or ACH/eCheck. The client can pay its entire outstanding balance or a specific invoice. If the client pays something less than the whole amount due, the system requires the client to add a note/message explaining why the entire payment due has not been made.
• Reconcile Payments – When the payment gateway authorizes the payment, XiFin RPM automatically posts the payment against the correct invoice. This automation streamlines the process for the XiFin customer.
• Price Inquiry – Clients can check their client specific price for a test as well as the associated CPT codes 24/7 online via the portal. This self-service tool not only provides client satisfaction, but also can greatly reduce the volume of incoming calls to XiFin customers.
• Line-Item Dispute – XiFin customers can also allow their clients to view invoice line-item details and filter line items through the portal. For example, the client could filter the line items to see all of the glucose tests in the invoice and quickly see the prices being charged for those tests. If a is client usually charged $10 for a glucose test but notices two instances where the charge was $50 for the same test, the client can enter a line-item dispute for those two $50 test charges. These two line items will automatically go into dispute status and be queued to be worked by the XiFin customer. If the XiFin customer agrees with the dispute, the customer can set up the adjustment, automatically lowering the balance due. If the XiFin customer disagrees that there is a pricing error, the full balance due will be added back to the invoice. The client has visibility into the dispute resolution process.
• Reassignment of Charges – Clients can also rebill a charge to a third-party payor from within the Client Portal, in which case the payor details can be input in the portal, and the charge is removed automatically from the client bill invoice. This streamlines what used to be a very manual, paper-intensive process and accelerates payment. The portal also allows clients to move charges to another Client ID. For example, an accounts payable team member at a hospital may be responsible for processing invoices related to six different Client IDs. Reviewing the current invoices, the team member may notice a charge applied to the pathology account that belongs to another Client ID. If the team member has permission, the charge can be moved to the correct Client ID, removing it from the incorrect invoice and applying it to the right one.

In summary, integrating client billing into the RCM process is a strategic move for healthcare providers. It helps reduce risks, streamline operations, improve cash flow, and enhance overall financial performance while ensuring a smoother experience for both providers and patients. Leveraging available RCM tools within this integrated framework can further optimize revenue management and billing efficiency.

Watch now to see a short demo of the XiFin Client Portal Client Invoice features.