Infinx Healthcare has partnered with XIFIN to launch an industry-leading laboratory revenue lifecycle solution that couples the Infinx Prior Authorization Software solution with XIFIN’s fully optimized RCM powerhouse financial system. With this complementary suite of technology services, a machine learning-enabled system is created that can integrate with a laboratory’s LIS to provide a state-of-the-art automated workflow.
We believe that by integrating with strategic partners with core competencies, like XIFIN, financial management is enhanced end-to-end, delivering maximized revenue and profitability by utilizing AI-driven technology.
With margins shrinking and reimbursement rates falling, the resultant increased reimbursement, streamlined processes, and reduced denials will positively impact the bottom line for both hospital outreach labs and clinical laboratories alike.
Streamlining Laboratory Prior Authorizations
As the menu of available genetic and molecular testing applications continues to grow, so do laboratory prior authorization requirements. While prior authorization responsibilities may rest with the ordering provider, often they are missing, or patient information is incorrect, creating a cascading follow-up process that wastes time and can impact patient care.
Prior authorizations can be processed before accessioning, or testing is even done by moving expectations to the point of care delivery. With an AI-driven software solution fully integrated with the lab’s LIS, required prior authorizations can be isolated, approvals initiated and sent, follow-up performed 24/7, and notification of successful resolution returned to the lab in real-time.
Using an intelligent automated system significantly reduces the need for burdensome manual follow-up (i.e., waiting on hold, faxing and refaxing, etc.), saving time and resources. A process that historically has taken from several hours, days or even weeks can now be accomplished in minutes.
To illustrate even more clearly, the 2019 CAQH Index looked at the average cost per transaction for manual versus fully-electronic prior authorization transactions and found that automating the process would save an average of $9.04 for providers. Couple that with estimated savings for insurance payers of $3.27, and the industry-wide savings per prior authorization would be $12.31. Add that savings to the increased revenue recognized as denials and write-offs decline significantly, and intelligent automation solutions speak for themselves.
Most importantly, not only will this increase and accelerate the reimbursement cycle, but it should greatly improve the patient’s experience and confidence in their care.
What About Emergent or Complex Prior Authorizations?
When analyzing solutions of this type, remember that while most prior authorizations can be handled in this manner, some may still require a more hands-on remedy. Any solution implemented must be coupled with a team of highly-trained specialists to handle the small percentage of emergent, acute, or complex requests that present as outliers.
Without a doubt, AI and machine learning capabilities are opening opportunities throughout healthcare and patient billing lifecycle. As the healthcare reimbursement structure continues to evolve, high definition solutions that equate to resource savings (from reduced administrative burdens) and revenue capture will pay for themselves and then some, easily bringing swift ROI to any laboratory organization.
With today’s technology advancements brought together through our partnership with XIFIN, laboratories, hospital outreach programs, and molecular diagnostic providers can facilitate patient access and improve their bottom lines through reduced costs and much greater revenue capture. When weighing the benefits of these technological advancements, consider that the financial savings recognized by applying automated and AI-driven software solutions far outweigh the cost for acquisition and implementation, both in terms of labor required and realized revenue.
Learn more about this exciting partnership with XIFIN and contact us to discuss automation and AI-driven prior authorization solutions that improve your laboratory revenue lifecycle and streamline the business operations process.