Reimbursement intelligence for healthcare
Care was delivered.The revenuenever followed.
More than 2,300 hospitals lost $48 billion in 2025 to denials and unrecovered bills.1 Some of those patients were insured the whole time and nobody could find the plan.
Integrex Health finds it from a name and a date of birth, across every payer and tells you who funds the plan and whose rules apply. Providers, labs, billing firms, clearinghouses and technology platforms use it.
1. Kodiak Solutions benchmarking data, March 2026.
The animation shows one patient record. She has coverage but arrived with no card and no member ID, so the bill went to her instead. Integrex Health finds her Blue plan with no member ID required. Then it identifies who pays her claims and which rules apply, funding type and situs, before the first request goes out. The record ends paid by the right party, under the right rules, and the loop repeats.
All payer discovery
Start with every payer, including the Blue plans
Send a name and a date of birth. We search every payer in one request, the commercial insurers, government programs and Blue plans that pay for care, and return the plan, the policy detail and who funds it. No member ID.
Blue Cross Blue Shield is 61 separate state plans plus the Federal Employee Program, and most of them cannot answer a coverage question without a member ID, the one thing a patient who arrived without a card cannot give. Integrex Health returns active coverage from all 61 with no member ID at all.
One mark per plan. Several states have more than one.
Read about All Payer Insurance DiscoveryFunding type
Then know who pays, and whose rules apply
Turn on the flag and the response carries one more line.
Most insured patients are covered through an employer, and the card does not say how that plan works. This is where employer sponsored plan intelligence meets revenue cycle management: who funds the plan, and where the plan sits, decide the rules every claim is paid under.
Funding type says who actually pays. Two patients can carry the same card. For one, the insurer pays and the insurer's rules apply. For the other, the employer pays and the insurer or an administrator only handles the paperwork, so the employer's plan rules apply. Nothing on the card says which, and a standard eligibility response does not either.
Integrex Health returns funding type with every coverage result: Self-Funded, Fully Insured or Unknown. When the eligibility response doesn't say who funds the plan, an AI model reads the plan details and gives its answer with a confidence score. If it isn't confident, we return Unknown rather than guess.
If another vendor already found the coverage, send us its results and they come back with funding type added.
How funding type is returnedThe Orchestration Layer
One answer, carried through every step
Finding coverage, checking it, getting a procedure approved and chasing the claim usually run as four separate tasks, and the Orchestration Layer connects them so one answer travels with the account through every step.
Verify
Confirm or locate active coverage
Classify
Self-Funded, Fully Insured or Unknown
Route
Send it down the right payer pathway
Authorize or Appeal
Under the rules of whoever funds the plan
Recover and Report
Bill the plan that pays, report the results
Keep what you already run
There is nothing to install. Send a batch file or call the API, and see results from your own data before you commit to anything.
How it fits what you already runBring us your hardest accounts.
Send a file of accounts where the coverage could not be found, and we will show you what comes back.
Schedule a conversation