CASE STUDY 2
INSURANCE DISCOVERY
Client:
National Wound Care Provider
Challenges:
- Incomplete demographic information provided by hospitals
- Unnecessary outreach to patients for collections
- Time consuming process to verify insurance coverage for self-pay accounts
Solutions:
- Weekly process validates self-pay accounts for insurance coverage
- Government, Managed Care and Commercial payers are prioritized and cascaded
- Payer specific data alignment corrects inaccurate demographics
- Medicare verification without SSN or MBI
Results:
- Reduced cost of outreach to patients
- 44% average success rate locating active coverage over 12 months
- Identification of Blue plans in 40+ states that had previously required an intensive, manual process to validate coverage
- Accelerated time to revenue with comprehensive solution that enters and submits claims in Practice Management System