CASE STUDY 3
INSURANCE DISCOVERY
Client:
Radiology and Imaging Firm
Challenges:
- Incomplete demographic information provided by imaging centers
- High volume low dollar procedures required a creative financial model for insurance discovery
- Time consuming process to verify insurance coverage for self-pay accounts
Solutions:
- Weekly process validates self-pay accounts for insurance coverage
- Medicaid, Managed Care and Commercial payers prioritized and cascaded
- Payer specific data alignment corrects inaccurate demographics
Results:
- 33% average success rate over 18 months locating active coverage with a 3X return on spend
- Identification of Blue plans that had previously required an intensive, manual process to validate coverage
- Accelerated time to revenue with comprehensive solution that automates entering and submitting claims in Practice Management System