What You Should Know:
–XiFin, Inc., announced the launch of its new Payor Rate Transparency Monitor, the first-of-its-kind interactive visualization tool that compares contracted rates published by UnitedHealthcare, Aetna, and Cigna.
The new AI monitor tool dives deep beyond mere averages, drilling down into specific billing codes and modifiers established by the Centers for Medicare & Medicaid Services (CMS). This granular data empowers providers to refine their managed care, market access, and contracting strategies in ways previously unimaginable.
Inform Diagnostic Provider Reimbursement Strategies
This granular data empowers providers to:
– Refine their managed care and market access strategies: By understanding the full range of contracted rates for common services, providers can identify lucrative opportunities and target their efforts effectively.
– Negotiate with confidence: Armed with actual reimbursement data, providers can enter negotiations with a clear understanding of the value they deliver and negotiate rates that reflect their true worth.
– Identify market trends: The Monitor sheds light on broader pricing patterns across the industry, highlighting inconsistencies and potentially unsustainable practices by certain payors.
The data analyzed by the Monitor comes from the Health Plan Transparency in Coverage Rule, but XiFin’s data scientists have meticulously transformed it into actionable insights through:
– Cross-payor visualizations: Easily compare rates offered by different health plans for the same services.
– Interactive bubble charts: Gain a clear understanding of the distribution of rates for specific codes, highlighting outliers and trends.
– Monthly code updates: Stay informed about evolving reimbursement landscapes with the addition of new codes every month.
“In a complex healthcare landscape, XiFin’s new Monitor empowers our customers with intelligence and insights to make informed, timely decisions that maximize reimbursement,” said Kyle Fetter, XiFin chief operating officer.