XiFin Introduces Empower AI Appeals Agent to Help Pharmacies Optimize Medical Billing Reimbursement

At NACDS Total Store Expo, XiFin showcases Empower CareALERTS for immunization engagement and Empower RCM, Empower AI, and agentic AI appeals capabilities designed to support expanding clinical services and specialty pharmacy

SAN DIEGO--(BUSINESS WIRE)--As pharmacies expand their role in immunizations, preventive care, specialty medication therapies, and other clinical services, they are encountering new opportunities to improve patient access — and greater complexity in billing and reimbursement, particularly for services and therapies covered under the medical benefit. At NACDS Total Store Expo (booth #1823), XiFin, Inc., a leader in AI-driven revenue cycle management (RCM), will showcase XiFin Empower CareALERTS®, Empower RCM, Empower AI, and the new Empower AI Appeals Agent, demonstrating how pharmacies can strengthen patient engagement, improve reimbursement performance, and scale clinical services more sustainably.

This transformation is poised to accelerate as federal policymakers work to enact legislation such as the Main Street Pharmacy Access Act, which would expand opportunities for pharmacists to provide and receive reimbursement for covered clinical services. In addition, specialty pharmacies in particular face growing medical billing and reimbursement complexity, as many specialty therapies and related services are covered under medical rather than pharmacy benefits. Together, these developments are increasing the need for sophisticated medical billing, revenue cycle management, and appeals capabilities.

The upcoming vaccination season illustrates one immediate opportunity for pharmacies to expand their impact. According to XiFin’s 2026 Pharmacy Transformation Outlook Survey, 98% reported offering immunizations, making vaccinations the most widely delivered clinical service among participating pharmacies. Immunizations also ranked among the strongest-performing clinical services from a reimbursement perspective.

To help pharmacies identify and engage eligible patients while addressing these growing reimbursement challenges, XiFin will showcase XiFin Empower CareALERTS. The solution uses prescription and state immunization registry data to identify care opportunities and deliver actionable smart clinical messaging within pharmacy workflows. By helping pharmacists proactively engage patients who may be eligible for recommended vaccinations based on CDC and ACIP guidelines, CareALERTS supports efforts to close immunization gaps, improve access to preventive care, and strengthen community health outcomes. In 2025, CareALERTS technology successfully increased companion immunizations by 17% among participating pharmacies, while increasing operational efficiency and freeing up pharmacists to deliver more patient care.

“The impact on our patients and our team members was immediate. The solution eliminated 1.7 million workflow vaccination tasks, dramatically improving our operational efficiency and freeing up valuable staff time,” said Whitney DuBois, Systems Manager of Data Operations at Kroger. “These early results have exceeded our expectations,” she added.

Beyond immunizations, the continued expansion of pharmacy-based clinical services and specialty pharmacy is increasing pharmacies’ exposure to medical billing requirements, complex coverage policies, documentation demands, denials, and appeals. XiFin Empower RCM for Pharmacy and Empower AI help organizations manage these workflows across the revenue cycle, while the new Empower AI Appeals Agent addresses one of the most labor-intensive components of revenue management.

The Appeals Agent evaluates payor requirements, analyzes supporting documentation, identifies applicable coverage criteria, assembles supporting evidence, and generates customized appeal packages and submits them to payors. By automating complex appeals workflows, the Empower AI Appeals Agent helps pharmacies reduce manual effort, improve operational efficiency, accelerate revenue recovery, and manage the growing reimbursement complexity associated with medical benefit services and specialty drug therapies.

The Empower AI Appeals Agent is part of XiFin’s broader Empower AI ecosystem, which helps streamline administrative tasks, improve reimbursement accuracy, prioritize work based on financial impact, reduce manual touches, and enable pharmacies to scale clinical services more efficiently while navigating increasingly complex payor requirements.

“Pharmacies are entering one of the most exciting periods of transformation in the industry’s history,” said David Pope, PharmD, Chief Pharmacy Officer at XiFin. “As pharmacists take on a larger role in delivering vaccinations, preventive services, and other clinical care, they have an opportunity to improve health outcomes for more patients than ever before. XiFin Empower solutions are designed to help pharmacies confidently seize that opportunity — connecting more patients to care, simplifying reimbursement complexity, improving operational efficiency, and supporting long-term financial sustainability.”

Visitors to booth #1823 at NACDS Total Store Expo can learn more about how CareALERTS works within pharmacists’ existing workflows to highlight vaccination opportunities and see live demonstrations of Empower AI Appeals Agent. To learn more or to schedule a meeting with XiFin during NACDS TSE, visit the XiFin event page.

About XiFin

XiFin is a healthcare information technology company that empowers organizations to navigate an evolving and increasingly complex healthcare landscape. The XiFin Empower AI RCM ecosystem and trusted data employ active intelligence and automation to reduce manual touches, coordinate workflows, accelerate customer innovation, and improve financial outcomes. Our comprehensive set of solutions — spanning revenue cycle management, clinical workflow enablement, laboratory information systems, and patient engagement — deliver The Power to Do Good^® so that healthcare organizations can do more good for more patients. Visit www.XiFin.com, follow XiFin on LinkedIn, or subscribe to the XiFin blog to learn more.