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Unlocking Market Access: Data-Driven Insights for Reimbursement Success
A molecular diagnostics laboratory faced significant challenges in expanding payor coverage and optimizing reimbursement. High denial rates, timely filing issues, and unclear Medicaid policies were major obstacles. The lab partnered with XiFin to leverage real-time RCM data and improve market access strategies.
Key Results
- Reduced Denials: Proactive appeals and policy adjustments resulted in fewer denied claims and faster reimbursements.
- Revenue Recovery: Discrepancy reporting helped identify a $2 million underpayment, which was successfully captured.
- Improved Contracts: Data insights strengthened the case for in-network agreements, increasing payor coverage and reimbursement rates.
- Enhanced Compliance: Continuous monitoring and early intervention improved audit preparedness and compliance.
Working with XiFin has been a game-changer for our market access strategy. Their data-driven approach and deep understanding of payor dynamics have allowed us to proactively address reimbursement challenges and secure better coverage. The collaboration between our teams has resulted in improved financial outcomes and greater patient access to essential diagnostics.
VP of Market Access
Click below to read the full success story and learn how XiFin’s data-driven insights transformed this laboratory’s market access strategy and led to improved reimbursement success.
