Coverage Discovery

For The sure ways solution We’ll lessen your revenue loss.

Simply said, patients’ lack of insurance or inadequate insurance is the main cause of the lost income from uncompensated treatment. Due to negligence or a personnel shortage, another portion is simply never billed internally by the medical billing department. However, it’s thought that up to 10% of self-pay accounts that are written off are in fact protected by chargeable insurance or a government health care program. This constitutes a large portion of the providers’ prior-to-now challenging-to-recover income.

Hundreds of billions of dollars have been lost in income as a result of uncompensated care. The Coverage Discovery team at The sure ways solutions searches for insurance that patients might not even be aware they have and secures all available reimbursements for our customers.

All of this potential growth in income comes from insurance that patients might not even be aware they have. Young adults might be unaware that they are still protected by a parent’s insurance policy. Another very typical circumstance is when a person is unaware that they are protected by a plan set up by their spouse. They frequently believe you will find out about a secondary coverage if you check for their primary coverage if they are aware of one. The complexity of Medicaid and Medicare, with all of its components, is difficult enough for specialists to handle. It seems sense that beneficiaries, who are frequently old or incapacitated, would expect your medical billing staff already has access to the information required to determine what all of their coverage entails, rather than doing the necessary investigation to sort it all out.

It is obvious that it would be difficult to individually investigate every potential payer for every single patient. Software tools made especially for the job are used by Coverage Discovery. When a patient states they are self-paying, we may help both the patient and the physician if there is any amount of coverage by automatically searching for it. The resources include sophisticated search functions, automated claim cleansing, a sizable database, and algorithms made to weed out false-positive findings and inaccurate conclusions.

• Recognizes all layers of protection to increase reimbursement
• Reduces the amount of accounts written off or sent to collections Decreases the cost of collecting overdue bills
• Decreases total bad debt
• Improves patient contentment

Verifying eligibility kicks off the Coverage Discovery process at the beginning of the medical revenue cycle. Before patients are ever seen by the physician, over one-third of claim denials and rejections are the result of upfront mistakes. Processes for registration and verification can be considerably improved for increased income. The following are just a few ways that Coverage Discovery helps the front-office procedure:

• Simplifies interactions between staff and patients
• Front-end collections are up
• Ensures accurate code matching
• Reduces rejects and denials by guiding staff

There will always be patients who are unable to pay the entire cost of medical care, but by giving accurate information to patients, disclosing prices up front, and charging all accountable payers, you may recover more of your earned income. The inability to determine who should be charged for services is no longer a valid excuse.