More Leading Hospital Laboratories Are Outsourcing Revenue Cycle Management

As value-based care initiatives and reform continue to put pressure on hospitals to decrease inpatient volumes, achieve outcomes goals, and provide cost-effective care, clinical services outsourcing is becoming a necessity. At the same time, based on XiFin customer analysis, many hospital laboratories fail to capture as much as 30% of the revenue that is due to them. This is especially true for outreach and ancillary laboratories that are managing their billing and revenue cycle management (RCM) processes through a hospital or health system-wide enterprise system. 

For hospital laboratories to contribute everything they can financially back to the health system, they need to:

• Maximize revenue cycle management through increased laboratory cash collections
• Have visibility into key performance indicators (KPIs) and benchmarking
• Be able to leverage business analytics and reporting to drive financial performance improvements

According to a 2019 survey of managers from 545 hospitals and inpatient organizations on healthcare outsourcing conducted by Black Book Market Research LLC, 90% of hospital leaders are evaluating whether to work with third-party vendors for cost efficiencies in both clinical and non-clinical functions. The Black Book survey results underscore that value-based care initiatives are triggering a sharp increase in clinical outsourcing partnerships. These partnerships offer hospitals the ability to quickly transfer day-to-day administration of noncore functions, such as technology and financial services, to outside vendors. In fact, Black Book’s research has shown a 300% increase in requests for outsourcing proposals since Q4 2017 among select functions.

The survey also revealed that the top two reasons for outsourcing services are cost savings/avoidance (selected by 85% of respondents) and the expertise of the outsourcing vendor (72%). According to survey authors, healthcare organizations are doing a much better job in assessing the need for outsourcing and selecting appropriate outsourcing vendors. However, many executives still have difficulty managing the outsourcing relationship through critical clinical, financial, and operational performance indicators.

The Black Book research also surveyed 4,000 client users regarding customer satisfaction and customer experience.  XiFin was ranked as the leader for Laboratory Support and RCM.

Clients who outsource their RCM to XiFin receive full-featured billing and revenue cycle management services, and support from a dedicated outsourcing billing group currently processing nearly $9 billion in gross laboratory claims. The XiFin outsource billing team uses the best practices XiFin has developed, working with many of the nation’s leading labs. XiFin brings this collective intelligence to each outsource client’s claim processing to minimize denials and optimize cash collection.

With XiFin, there are no “black box” operations. The XiFin purpose-built laboratory RCM solution ensures our clients have complete visibility at all times. Our outsource clients can access the RPM platform to view, in real-time, all claims that are being held for billing due to missing or incorrect information, rejections, denials, and appeals. Our team and yours can monitor workflows and progress at all times, so no claim ever falls through the cracks. Regardless of the billing option you choose, with XiFin, you can count on higher performance, increased revenue, and more profit.