Coverage Insight™

An analytics-driven solution for providers that want to identify undisclosed coverage for patients presenting as self-pay or underinsured, while adhering to anti-phishing regulations.

Identify Undisclosed Coverage

Help increase revenue by detecting undisclosed reimbursement sources within 2-24 hours.

Pay only for accounts that yield a net gain via a percent or fixed-fee per benefit unit.

Minimize the risk of PHI compromise by using a solution designed to meet the anti-phishing mandates of CMS and payers.

Help increase patient satisfaction by identifying coverage that reduces out-of-pocket costs.

Help reduce the risk of bad debt associated with accounts mislabeled as self-pay or charity care.

Facilitate time-and-cost savings by helping to reduce backend collections.

Tap New Sources of Reimbursement

Choose an intelligent solution

We use advanced data mining, machine-learning algorithms, predictive analytics, our expansive network of payers, and more than 600 internal and external sources to identify existing insurance coverage.
Our solution helps to verify data accuracy using direct payer and third-party connections to confirm a patient’s benefits and the applicability of all discovered information.
Irrelevant information is suppressed by screening the byproduct of self-pay and eligibility processes to determine which information has historically been useful.

Reduce anti-phishing risk

Intelligent analytics create an in-depth demographic profile of each patient using both historical and current data such as names, addresses, employers, prior insurance coverage, MVA reports, etc.
Algorithms look for trending elements to compare against historical data, such as income strata and carriers associated with specific residential areas, to predict coverage and create an insurance profile.
Coverage Insight validates the demographic and insurance profiles are one-and-the-same. Our suppression feature rejects an average 40% of accounts due to identity risk to deliver highly-reliable data back to the provider.

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