The Hidden Cost of Inconsistent Claim Frequency Code Use

A Call for Industry Alignment

The Hidden Cost of Improper Claim Frequency Code Use spotlights a growing industry challenge: the increasing misuse of full replacement claims (CFC 7) when a simple resubmission with additional information (CFC 1) is appropriate. Drawing on real‑world data, XiFin shows how this shift—most common among Medicare Advantage and managed care plans—deviates from long‑standing standards and introduces unnecessary friction, cost, and risk into the revenue cycle management process.

Download this paper to explore:

• How requiring full claim replacements for single denied line items disrupts the reimbursement process, causing inefficiency, rework, and risk
• Why inconsistent CFC requirements undermine interoperability and create confusion for providers, payors, and patients alike
• Which laboratories face especially severe consequences as a result of this inconsistency
• Recommended approach for industry alignment, defining a standards‑based workflow that reduces administrative waste and supports simplification, consistency, and enforcement to protect margins.

Download the white paper now.