Opportunity

Ambry Genetics is a leader in bringing innovative products and comprehensive genetic analysis to market quickly, enabling clinicians to confidently inform patient health decisions. According to Chief Operating Officer, Linh H. Le, Ambry sets itself apart from other molecular diagnostic laboratories through its laser focus on patient centricity and patient engagement throughout the company.

To achieve optimal patient access and satisfaction, the Ambry team concentrates on having the best people, superior processes, and the right tools and systems. In 2019, the operations team identified that its current revenue cycle management (RCM) system was neither robust nor scalable enough to meet the growing demand and corporate objectives. They were seeking an RCM solution to facilitate and enhance the patient experience, provide business intelligence that integrates with their enterprise resource planning (ERP) system, and gain multi-faceted services and expertise.

After an RFP process in which several RCM solution providers were evaluated, the team selected XiFin RPM.

Solution

The Ambry team was quick to make use of many of the XiFin RPM capabilities and prioritized the utilization of the patient out-of-pocket expense estimator and the patient portal. Many genetic labs with customized testing solutions have struggled with how to best provide their patients and physicians price transparency during the ordering process. Ambry knew that this was an area where technology could enhance both the patient and physician experience. By providing the information early in the ordering process, Ambry enabled providers and patients to comfortably move forward with ordering, while software automation ensured efficient and timely action. With an increase in high-deductible insurance plans and limits on coverage through employer-sponsored plans, patients are experiencing higher out-of-pocket costs. An accurate understanding of a patient’s financial responsibility is an increasingly important aspect of patient satisfaction.

XiFin and Ambry collaborated on the development of additional methods of communicating with patients with respect to the out-of-pocket expenses. Through this cooperative approach, XiFin developed near real-time text and email notifications to patients when their patient responsibility estimations were ready for review. Ambry is the first XiFin client to provide the ability to notify patients that they can retrieve their estimated out-of-pocket expense via text message, provide the ability for patients to approve the estimate, move forward, and prepay for the test all through the XiFin RPM patient portal.

Ambry can now offer improved patient self-service capabilities with secure access to their account data any time and make real-time payments online. Ambry found the benefits of offering the patient self-service tools to include:

• Increasing productivity of customer service and billing staff, which lowers cost
• Reducing days sales outstanding (DOS) and write-offs
• Automating credit card payments
• Improving patient access, convenience, and engagement

The patient portal also creates an additional touch point to increase engagement by presenting balances, notifications, prepayment, and billing options, all of which result in greater patient satisfaction and an improved collection process.

Improving the Patient Experience

The molecular diagnostic business is one where sometimes staff members can feel one step removed from the patient. The team at Ambry never loses sight of the fact that the ultimate goal of a laboratory is the proper diagnosis and treatment of the patient and that labs play an exceedingly important role in enabling clinicians to do so. As such, they place the patient at the center of everything they do, from the order to the testing process, the report creation and distribution, all the way through to the payment for the work completed.

The Ambry leaders choose technology and service partners who embrace and enable their patientcentric approach. From an RCM perspective, this means making sure patients have transparency into their likely out-of-pocket cost, claim status, insurance reimbursement, and ultimately their balance due for payment. The Ambry team identified several key metrics to measure success. They used the robust XiFin RPM business intelligence, reporting, and benchmarking capabilities to:

• Continuously improve processes and performance
• Shorten turnaround time (the time from when a sample is received to when the lab report is returned to the ordering clinician)
• Better understand patient needs
• Further increase patient engagement and satisfaction

These outcomes reflect the combination of the right technological capabilities, patient-centered services, and a collaborative relationship. This willingness to innovate and develop what is needed to serve the needs of the laboratory, their referring physicians, and ultimately the patients is proven to improve financial performance.

The team at Ambry Genetics exemplifies the very best practices when it comes to patient engagement and satisfaction. Their patient-centric approach to everything they do improves communication and creates trust with the patients they serve. The organization is focused on continuing to grow through having the best people, the right processes, and the appropriate systems and tools. This approach also facilitates access by patients to the data they need to have confidence in the lab. Easing the burden for patients while also optimizing cash collections is a top priority for the revenue cycle management process at Ambry, and it works.