Xifin Inc, San Diego, has entered into a strategic partnership with Glidian, Palo Alto, Calif, to develop expanded patient and physician engagement capabilities. The new capabilities include a patient responsibility estimator, as well as automated prior authorization capabilities integrated with Xifin’s revenue cycle management and laboratory information system solutions, Xifin RPM and Xifin LIS.
Driven by higher copays, increased participation in high-deductible healthcare plans, and claim denials due to prior authorization requirements not being followed, patient out-of-pocket expenses are at an all-time high. Patients are now responsible for 30% of healthcare revenue, and the added expenses are becoming a significant driver of patient dissatisfaction. The trend is also a factor in growing health consumerism, with patients demanding cost transparency and better access to their diagnostic information.
Laboratories and remote patient monitoring companies have an opportunity to enhance patient engagement and physician satisfaction by providing tools that offer insight into costs and improve access to the diagnostic tests or health monitoring that physicians recommend.
“The way in which patients interact with the healthcare system continues to evolve, and their expectations are growing,” explains Lâle White, CEO of Xifin. “With our new responsibility estimator, we are uniquely positioned to help diagnostic providers improve their patient engagement and experience initiatives. In addition, our partnership with Glidian builds on our commitment to also improve physician satisfaction by streamlining prior authorization workflows to generate increased efficiencies and reduced denials—ultimately enabling physicians to provide more timely care to patients.”
Unlike current billing processes with limited ability to provide financial information, Xifin’s patient responsibility estimator enables diagnostic providers to give patients a better understanding of their out-of-pocket costs for ordered tests, and to provide a prepayment option. The estimator is available through Xifin’s multiportal infrastructure that serves patients, providers, and clients.
Each year, $31 billion is spent on prior authorizations. According to a 2018, nearly 90% of physicians say that prior authorization burdens have increased during the past 5 years, and 28% say that prior authorization delays have led to a serious adverse event.1 With physicians completing an average of 31 prior authorizations each week, and more than a third of physicians employing staff who work exclusively on prior authorizations, it is clear that prior authorizations are costly activities.
“Xifin and Glidian have provided the ability to streamline the prior authorization workflow for my team,” says Irene Jivani, director of strategic partnerships at Baylor Genetics. “Our verifiers are able to track their prior authorizations in real time, cutting down the turnaround time in providing decisions to our clients and patients. Integration of the tool was simple, and minimal training was needed, which makes this solution incredibly user-friendly.”
Using Glidian’s automated prior authorization process, and building on the prior authorization workflow, logic, and document storage already available, the Xifin system enables diagnostic service providers to increase revenue by reducing prior authorization-related denials. Knowing the workflow of prior authorizations starts at the physician’s office, the Glidian application works with Xifin LIS so that physicians or diagnostic providers can initiate the prior authorization process as early as possible.
“Securing prior authorizations can be time-consuming due to disconnected systems and manual processes—all of which can lead to delays in patient care,” says Ashish Dua, CEO of Glidian. “By integrating our electronic prior authorization submissions with Xifin RPM and Xifin LIS, we’re able to help providers streamline their workflows, prevent denials, and help expedite decisions to make sure patients receive the important diagnostic information they need.”
- 2018 AMA Prior Authorization (PA) Physician Survey [online]. Chicago: American Medical Association, 2019. Available at: www.ama-assn.org/system/files/2019-02/prior-auth-2018.pdf. Accessed February 20, 2019.