Precision Diagnostics Company Optimizes Revenue Cycle Management for a High-Complexity Laboratory Test

After acquiring a high-complexity molecular diagnostic test, this precision diagnostics company initially outsourced its billing operations. However, the manual, error-prone workflows used by the third-party billing vendor led to inefficiencies, increased costs, and lower reimbursement rates.

To take control and improve performance, the company transitioned billing for the acquired test in-house using XiFin^® Empower RCM, implementing automation and system integration to scale more effectively and cut costs.

Key Results

• 12% Increase in Average Sales Price (ASP): Optimized payor management and improved appeals strategies resulted in an average of $50 higher reimbursements per test.
• 50% Reduction in Billing Costs: The shift from outsourced billing to in-house and applying robust automation cut costs by more than half, eliminating unnecessary expenses.
• Higher Efficiency and Reduced Human Error: Automated processes such as prior authorization, eligibility checks, and documentation management reduced manual errors and improved claim accuracy.
• Improved Financial Forecasting and Reporting: Combining data from Empower RCM and the customer’s LIM system provides enhanced financial visibility into reimbursement trends, allowing for more precise revenue forecasting.
• Optimized Collection Strategies: The company established payor-specific collection targets to maximize reimbursements while streamlining workflows through automated exception processing.

Read the full success story to learn how this customer achieved a measurable ROI with Empower RCM by automating key workflows, implementing payor-specific strategies, using real-time data insights, and integrating systems through APIs to streamline billing and accelerate reimbursement.