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XIFIN Enhances Prior Authorization and Appeals Automation Capabilities to Improve Reimbursement for Diagnostic Providers
[November 19, 2019]

XIFIN Enhances Prior Authorization and Appeals Automation Capabilities to Improve Reimbursement for Diagnostic Providers


XIFIN today announced prior authorization and appeals enhancements to its revenue cycle management platform XIFIN RPM, and a strategic partnership with Infinx to reduce the associated administrative burden, cost, and complexity. Now, XIFIN diagnostic clients have multiple options in how they can secure and manage prior authorizations for proprietary, esoteric and toxicology testing, and remote patient monitoring, helping improve reimbursement and workflow, and reduce labor costs.

Together, XIFIN and Infinx directly impact diagnostic providers' bottom lines by increasing their revenue through improved reimbursement rates and decreasing the administrative labor costs of complex diagnostic tests and remote patient monitoring devices. XIFIN RPM clients benefit from enhanced revenue cycle management automation, including front-end payor and CPT code-specific workflow configuration, back-end exception processing, and automated appeals workflow.

The Infinx prior authorization software is a cloud-based solution driven by AI and automation, and human expertise to deliver a best-in-class approach to patient access. The integration of technology and certified prior authorization specialists gives providers complete coverage of their prior authorization workflow from determination, initiation, status follow-up, through to verification of each authorization.

"Through our partnership with XIFIN, the combined solutions will improve efficiencies, workflows and will benefit the bottom line for many diagnostic providers," said Jaideep Tandon, CEO, and co-founder of Infinx. "Our prior authorization software and specialists that support several healthcare specialties are able to obtain a prior authorization 98% of the time resulting in a 55% decrease in costs, and a 10% boost in reimbursements. By integrating our software with XIFIN RPM, our technologies will address a huge reimbursement bottleneck by automating the prior authorization workflow."

"Prior authorization clearly remains one of the most complicated problems in the industry, affecting diagnostic labs, medical device companies, providers and patients," said Lâle White, executive chair and CEO of XIFIN. "Collaborating with Infinx is a continuation of our commitment to overcome this issue. By expanding our capabilities and partners, we provide our customers with the automation options they need to improve their prior authorization processes, lower costs and reduce related denials. It is vitally important that patients eceive the care they need, and that diagnostic providers manage their testing with maximum efficiency and are reimbursed appropriately for their efforts."



Health plan prior authorization policies continue to increase, putting an immense burden on clinicians, diagnostic professionals and patients. According to a recent survey from the American Medical Association, 88% of physicians reported an increase in prior authorization burdens over the past five years, with more than 90% reporting that prior authorizations delayed patient care and 75% reporting that prior authorizations can lead to abandoned treatment. As healthcare costs continue to rise, it's critical that providers and payors turn to technology and automation to address inefficiencies and reduce avoidable denials.

Through the analytics available within XIFIN RPM Business Intelligence, as well as cross-customer trend data, XIFIN has identified the following prior authorization statistics:


  • Prior authorization-related denials across all customers have increased 311%, including a 92% increase specific to proprietary testing and 52% for molecular testing.
  • Women's health prior authorization-related denials have increased by 62% in the last 24 months, representing a cash impact of $98.72 per procedure to non-invasive prenatal testing providers.
  • Cardiovascular disease-related prior authorization denials have increased more than 54% in the past two years.

XIFIN RPM is a machine learning-enabled revenue cycle management platform that optimizes billing and accounts receivable processes, as well as financial reporting and management. It also intelligently automates revenue workflow, facilitates claim and appeal filing, and reduces regulatory compliance risk.

XIFIN serves four of the five largest IDNs and seven of the top 10 labs in the United States.

To learn how to optimize your revenue cycle management process with prior authorization and appeals automation please visit www.xifin.com/priorauth.

About Infinx Healthcare

Infinx Healthcare provides innovative and scalable prior authorization and revenue cycle management solutions for healthcare providers, hospitals, imaging centers, orthopedics, and laboratories. Infinx helps clients preserve and capture more revenue. By combining intelligent, cloud-based software driven by artificial intelligence and automation, with exception handling by certified prior authorization and billing specialists, clients can shift focus from burdensome administrative details to billable patient care. For more information, visit http://www.infinx.com.

About XIFIN, Inc.

XIFIN is a healthcare information technology company that leverages diagnostic information to improve the quality and economics of healthcare. The company's cloud-based technology facilitates connectivity and workflow automation for accessing and sharing clinical and financial diagnostic data, linking healthcare stakeholders in the delivery and reimbursement of care. To learn more, visit www.XIFIN.com, follow XIFIN on Twitter and LinkedIn, or subscribe to the XIFIN blog.


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