Through one of the most challenging years for the healthcare industry, XIFIN contributed thought-provoking articles to help traverse these difficult times. Here are 2020's most popular blog posts.
1. How Upcoming Changes to United Health's Laboratory Test Registry May Impact Your Lab
When the COVID-19 pandemic was declared, United Healthcare (UHC) delayed implementing the Laboratory Test Registry Protocol several times, most recently to January 1, 2022. On that date, UHC starts requiring in-network, free-standing, and outpatient hospital lab providers' claims for test services to contain a unique code for each service. Each test code on a claim must match a laboratory test registration.
UHC now is requiring laboratories to register their tests through the UHC Laboratory Test Registry by December 1, 2021. These requirements apply to most UnitedHealthcare Commercial, Medicare Advantage, and UnitedHealthcare Community Plan networks.
Claims for in-scope laboratory test service must contain the appropriate lab test codes. Clients will use these test codes to order each test. On January 1, 2022, the test codes will uniquely identify each test for each laboratory.
Read the full blog post for source material, exceptions to the requirements, and what XIFIN clients need to know to pull in some of the data requirements to bulk load new test codes.Read Now
2. Business Intelligence and Advanced Analytics Deliver New Data Insights for Diagnostic Providers
XIFIN Vice President of Engineering Jeff Carmichael says that both data scientists and historians rely on primary data sources and sometimes secondary data sources. But the challenge of using secondary sources is that it has already had someone else's interpretation applied.
That's why XIFIN invests in solutions that deliver quality data from primary sources that clients can rely on to make data-based decisions. The goal is to limit the incidental interpretation. XIFIN's business intelligence capabilities and Advanced Analytics platform pull data directly from the source application.
Learn more about the significance of a revenue cycle management system that lets clients see a complete dataset that's prepared in a series of top-level visualizations with all the details built-in.Read Now
3. Automation of Prior Authorizations and Appeals Is Possible and Key to Reducing Costs
Among the top issues challenging diagnostic providers' ability to maximize revenue are the significant increase in required prior authorizations (PA) and the high cost of appeals.
These challenges are even more difficult for laboratories and remote patient monitoring device companies that use traditional billing systems with no or few automation tools. Without strong automation for dealing with PA and appeals, labs tend to develop the unattractive practice of writing off PA-related denied claims.
Learn more about the detrimental effects of PAs and appeal costs and how you can maximize revenue with automation.Read Now
4. Deciding to Outsource Your Revenue Cycle Management (RCM) or Do It Yourself? Key Considerations
Success depends on your ability to achieve operational efficiency, whether that's throughout a hospital, health system, independent laboratory, or independent diagnostic testing facility (IDTF). Diagnostic leaders know that to improve the organization's profitability, it's critical to gain efficiency and effectiveness in their revenue cycle management (RCP) process.
This leads to an important question: Should you manage the RCM process in-house or outsource to an RCM provider?
Learn the best way your diagnostic organization can gain control and visibility over financial operations, optimize revenue, and maximize cash collection, regardless of how you choose to manage RCM.Read Now
5. Is the FDA on a Dangerous Path? Overstepping LDT Authority Hampered COVID Response and Has Long Term Consequences for US Healthcare
FDA overreach contributed largely to testing delays and a hamstrung response during the early days of the COVID-19 pandemic. Just how does the FDA's overstepping pose a risk going forward?
XIFIN Executive Chairman & CEO Lâle White discusses the Yale Law Review-published essay, "Deadly Delay: The FDA's Role in America's COVID-Testing Debacle," and why laboratory leaders need to fight the VALID act and voice their concerns.Read Now