For 13,156 Medi-Cal accounts, we identified active coverage for 10,959 rows, corrected 2,915 names and dates of birth, resolved 617 incorrect member IDs, and uncovered Managed Care Organizations or IPAs for 8,397 rows.
Insurance Discovery
An RCM firm serving hospitals and clinics achieved a 30% success rate in locating active coverage, a 2.5X ROI, and improved resource efficiency by implementing a daily insurance validation process and customizing output files for claim submissions.
A radiology firm achieved a 33% success rate in locating active coverage, a 3X return on spend, and faster revenue cycles by automating claim submissions, prioritizing payers, and streamlining Blue plan validation through weekly insurance verification.
A national wound care provider achieved a 44% success rate in locating active coverage, faster revenue cycles, lower patient outreach costs, and streamlined Blue plan validation through weekly insurance verification and payer prioritization.
A pathology-focused RCM firm improved insurance validation, achieved a 40%+ success rate in locating active coverage, and enhanced efficiency by integrating Integrex RCM API in NextGen.