Coverage Discovery Services
At WeCare We can cut Your Revenue Loss
A large portion of unrecovered revenue is due to patients being uninsured or underinsured. Some losses result from oversights or overwhelmed billing staff. Yet, an estimated 10% of written-off self-pay accounts might have viable insurance or government program coverage. This untapped revenue has traditionally been challenging to reclaim.
Coverage Discovery Services Increase Revenue
Billions in revenue is lost to uncompensated care. WeCare’s Coverage Discovery team identifies unknown patient coverages, ensuring maximum reimbursements for our clients.
What’s Behind The Lost Revenue
Many patients are unaware of additional coverages they possess. Young adults might be unaware of coverage under a parent’s plan, while others might overlook spousal plans. Patients frequently assume secondary coverages are automatically identified when primary ones are looked up. Navigating Medicaid and Medicare’s intricacies can be daunting even for professionals. It’s reasonable for the often elderly or disabled recipients to assume your billing team has access to comprehensive coverage details.
How WeCare’s Coverage Discovery Service Works
Manually researching potential payers for every patient is unfeasible. Coverage Discovery employs specialized software tools for this purpose. By auto-checking for coverage when a patient declares as self-pay, we aid both patient and provider if coverage is detected. These tools encompass advanced search capabilities, automatic claim refinement, an extensive database, and algorithms to prevent inaccuracies and false positives.
Benefits of Using Coverage Discovery
- Pinpoints every layer of coverage to optimize reimbursement.
- Reduces days in accounts receivable (AR).
- Lowers the number of accounts directed to collections or marked off.
- Cuts down collection costs for unsettled bills.
- Diminishes overall bad debt accumulation.
- Enhances patient contentment.
Improve Front-end Eligibility and Benefit Verification
The Coverage Discovery process kicks off with eligibility verification at the medical revenue cycle’s onset. With about a third of denials stemming from initial errors before provider visits, refining registration and verification can notably boost revenue. Key benefits of Coverage Discovery for the front-office include:
- Simplifies staff-patient communication
- Boosts initial collections
- Ensures accurate code pairing
- Offers direction to employees
- Minimizes rejections and denials
Minimize Bad Debt and Write-Offs
While some patients can’t afford full medical costs, with accurate information, upfront pricing, and billing all liable payers, you can maximize revenue collection. No need to leave services unbilled due to billing uncertainties.
Front-end and Billing Staff Value Coverage Discovery
Both front-end and billing staff value our services, as they streamline their tasks and enhance efficiency. This allows them to concentrate on their top-priority responsibilities.
Efficient Registration Process
An efficient registration process empowers staff with accurate information, enabling informed conversations with patients. When patients understand their bills and responsibilities, payment likelihood increases. While some may struggle with medical costs, transparent billing and flexible payment plans can enhance collection rates, making the process more patient-friendly.
Qualified Billing Staff
Having accurate insurer/payer details aids billing staff. Proper code matching boosts claim approval rates upon submission and simplifies the process as relevant codes are pre-identified.