Exagen Inc. (NASDAQ:XGN) Q2 2023 Earnings Call Transcript

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Dan Brennan: Great. Thank you very much. I’ll get back in the queue.

Operator: Thank you. Our next questions come from the line of Mark Massaro with BTIG. Please proceed with your questions.

Mark Massaro: Hi, guys. Thanks so much. Congrats on the strong revenue growth and reduction in cash burn. I guess, one for you, John. You’ve outlined a lot of changes to revenue cycle management. And certainly, I appreciate a lot of the color that you provided. I think it’d be interesting to get your sense for like what inning do you think we’re in with the changes to revenue cycle management? I’m just trying to determine how much continued improvement do you think we can see as we think about the business into 2024 and beyond?

John Aballi: Great. Good morning, Mark. Thanks for joining the call. Thanks for the question. What inning we’re in? I love it. I love the baseball analogy, especially given the season. So from my standpoint, I think we’re early innings. And the reason I say that is because we put a lot of work in terms of prepping. That’s what I’ve considered much of the first half of 2023 to be, a lot of game planning there. And we’re starting to put some of those efforts into play really, right? So the whole point of holding claims — just to give context to those comments. The whole point of holding claims was that we didn’t trigger timely filing deadlines for our appeals process. And the core — kind of a core tenet to our improvement in revenue cycle operations is improving the way we do appeals.

I think that’s really where the rubber meets the road in terms of impact for us longer term. And so I wanted to postpone as long as possible really the timely filing deadlines that would be associated with claim denials. And so as we started to release those, I expect — for the claims that we are going to be denied on, I expect to start seeing those come in sometime around September-ish into October. And then that will be our first round of appeals. I’ve tried to detail this in the past. But just to refresh everyone, I think that we’re going to have the opportunity to appeal somewhere around three times. That third level of appeal is oftentimes associated with an external review by a specialist. And that’s where we think really the value of the clinical data we’ve assembled and the value proposition will resonate most with that reviewer.

So from our standpoint, we’ve — it’s always been tough to nail down exact timing. But what we’ve tried to maintain consistency in communicating is sometime towards the end of this year and really into 2024, our growth will be a combination of both volume and ASP growth, our revenue growth that is, but it will be largely driven by ASP growth. And I think that that’s really the opportunity for the organization. Again, I think that’s the most sensitive lever we have to employ in growing this organization. We have substantial volume. We’ve shown we can continue to grow that volume with the current sales footprint, and we just need to pursue I think more profitable business from our standpoint. I’ve also detailed — the list price of AVISE CTD is $1,650.

And our Medicare rate for AVISE CTD is $1,067. You see our quarterly ASP was in the 330 range this quarter, our trailing 12 months is about 320. So we’re moving along in the right direction. I think they’ll have some quarter-to-quarter gyrations, but generally so far I like the trajectory we’re moving in, and I think we need to get to that $500, $600 range on an ASP level to really have some — transform the organization. So hopefully, that gives you some context to timing and how we’re thinking about it.

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