Transforming Prior Authorization:
How a National Laboratory Achieved Measurable Gains with careviso and XiFin
Rising administrative burdens are causing delays in testing, slowing patient access to critical diagnostics and care, and straining healthcare operations nationwide. Healthcare provider organizations nationwide face mounting challenges in meeting payer policies and documentation requirements, particularly regarding prior authorization (PA) processes.
Before partnering with careviso and XiFin, one large national laboratory that specializes in complex diagnostic testing faced a range of operational challenges, with prior authorization being one of several areas creating friction across the revenue cycle. The significant PA challenges faced by this laboratory team included:
- Lengthy turnaround times between submission and approval
- High administrative workload due to manual data entry
- Inconsistent approval rates across payer networks
- Limited visibility into payer requirements and patient cost estimates
Results Summary
After switching to careviso and XiFin, the laboratory recorded substantial improvements across operational and performance metrics:
- Average time to submit prior authorizations decreased 48%, from 3.1 days to 1.6 days
- Average time to close prior authorizations decreased 53%, from 8.1 days to 3.8 days
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456 (58%) of sampled payers experienced increased approval rates and other benefits:
- 13.5% increase in paid claims
- Average increase of $347.33 in payment per procedure
Read the full success story to learn how partnering with careviso and XiFin delivers measurable results and lasting impact across the entire prior authorization workflow.
At-A-Glance
As one of the industry’s leading healthcare technology companies, careviso created a complete technology platform, seeQer, that increases patient access to care by delivering cost estimates, administrative requirements, and approvals in real time through streamlined workflows. careviso began with a laboratory-focused approach and has expanded to serve a wider population in healthcare. Our mission is to support patients, providers, and payers with total access to healthcare. By automating the impossible, we’re solving the most complex problems in the healthcare industry: prior authorizations and financial transparency.