New & Noteworthy

March 2024

Rate Monitor for Reimbursement


XIFIN launches the Payor Rate Transparency Monitor, an interactive visualization tool that compares published contracted rates from healthcare insurance providers. The Monitor allows transparency of contracted rates across health plans by focusing on specific billing codes and modifiers that have been developed by the Centers for Medicare & Medicaid Services (CMS). These data can help laboratories in defining and refining their managed care, market access, and contracting strategies, by showing the range of contracted rates for the most common services, as well as actual reimbursement rates. The Monitor allows users to explore in-network contract rates, spotlight detailed visualizations with interactive bubble charts and comprehensive analyses, and examine new codes monthly. The PRTM does not show actual reimbursement rates. PRTM data can be compared to a provider’s own actual and contracted reimbursement data.

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