Opportunity

Cockerell Dermatopathology (CDP) is a physician-owned practice with a family-oriented mission focused on diagnostic excellence and continuing education. CDP was managing its revenue cycle management (RCM) and diagnostic coding with a vendor that outsourced much of its work to overseas staff. This caused communication issues and delays due to a significant time difference. The vendor also experienced high turnover with the overseas staff, meaning the CDP billing manager was constantly training new personnel on client-specific rules.

After a significant error on the part of the vendor, the CDP team knew it needed to immediately find an alternative solution. The practice moved to another RCM vendor, which proved to be an interim solution. The team at CDP ultimately evaluated four different billing and RCM systems and chose XiFin RPM due to the system’s ability to track expected reimbursement amounts, compare it with collected amounts, and work any variances in a timely manner without the need for additional CDP staff.

Solution

Cockerell Dermatopathology selected XiFin RPM in 2013. XiFin RPM is a comprehensive revenue cycle management system, purpose-built for the complex, high speed, high volume laboratory environment. It optimizes billing and accounts receivable practices, automates the RCM workflow, facilitates claim filing, and reduces regulatory compliance risk. This results in improved financial performance – both lower costs and higher cash collections. The CDP implementation took approximately 90 days, during which the CDP billing manager took control of managing denials, customer service, logic optimization, etc., from the prior RCM vendor.

Cloud-based XiFin RPM helps organizations succeed by not only maximizing operational efficiencies and reimbursements, but also by delivering detailed, actionable business visibility and insight to support making better business decisions down to the client level. XiFin RPM comes with enterprise-grade business intelligence (BI). Together these RCM and BI capabilities helped put CDP back in control of its data and reporting. The CDP team now has the complete system access that they sought. XiFin RPM also provides direct connections to clients and patients though engagement portals that make it faster and easier to request any missing or incomplete data required for claim processing.

Results

While XiFin RPM is easy to use, CDP has an especially proactive billing manager, Tiffany Diamond, who has taken full advantage of the system to drive results previously unattainable for CDP. She quickly began improving CDP’s operational and financial results. For example, Tiffany can now create her own custom reports in RPM business intelligence. She builds her own queries to help her team identify new ways to optimize its RCM process, including keying in on items such as the following:

• Denial codes
• Test groupings
• Payor logic
• Client logic
• Eligibility translations

In conjunction with the XiFin team, CDP has configured XiFin RPM so that approximately 90% of errors and denials are now handled automatically, which means speedier submittals and remittance. The CDP team is able to fix issues at the root cause to prevent the same issues from reoccurring. Now, the majority of claims come in, go out to payors, get paid, and close – all electronically. Of course, some claims still require manual intervention, but the CDP team knows what to look for and can concentrate on these outliers to get them moving again toward payment. In addition, the CDP team is consistently keeping 98% of its exceptions/errors under 60 days old – further evidence of how well the team is managing its accounts receivable (A/R). The CDP team is also able to balance most of its payments daily to be posted the next day.