Coverage Discovery Services
At Remote Expert Solution We can cut Your Revenue Loss
A significant portion of lost revenue from uncompensated care stems from patients being either uninsured or underinsured. Additionally, some revenue is never billed due to oversight or overwhelmed in-house medical billing staff. However, it’s estimated that up to 10% of self-pay accounts written off could actually be covered by billable insurance or a government health care program. This represents a substantial portion of providers’ revenue that has, until now, been challenging to recover.
Coverage Discovery Services Increase Revenue
The revenue lost due to uncompensated care amounts to hundreds of billions of dollars. Remote Expert Solution’s Coverage Discovery team diligently identifies coverage that patients may be unaware of and secures all available reimbursements for our clients.
What’s Behind The Lost Revenue
The potential for increased revenue lies in uncovering coverage that patients may be unaware of. For instance, young adults might not realize they’re still covered under a parent’s plan, while others may not be aware of coverage arranged by their spouse. Patients often assume that if they disclose secondary coverage, their primary coverage information will automatically be accessed by medical billing staff. However, the complexity of programs like Medicaid and Medicare, coupled with the challenges faced by professionals in navigating their various parts, can make it difficult for recipients, particularly the elderly or disabled, to research and understand their coverage options.
How Remote Expert Solution’s Coverage Discovery Service Works
Manually researching all potential payers for each patient would be impractical. Coverage Discovery utilizes specialized software tools tailored for this purpose. These tools automatically check for coverage when a patient indicates they are self-pay, benefiting both the patient and provider if any coverage is identified. They feature advanced search capabilities, automatic claim scrubbing, a vast database, and algorithms to mitigate incorrect conclusions and false-positive results.
Benefits of Using Coverage Discovery
- Maximizes reimbursement by identifying all coverage levels
- Decreases accounts receivable days
- Reduces accounts sent to collections or written off
- Lowers collection costs for unpaid bills
- Minimizes overall bad debt
- Enhances patient satisfaction
Improve Front-end Eligibility and Benefit Verification
The Coverage Discovery process initiates at the outset of the medical revenue cycle through eligibility verification. Approximately one-third of claim denials and rejections result from errors occurring at the initial stages, before patients receive care from the provider. Enhancing registration and verification procedures presents a significant opportunity to enhance revenue. Some of the ways Coverage Discovery enhances the front-office process include:
- Streamlining staff interactions with patients
- Boosting front-end collections
- Ensuring accurate code matching
- Offering guidance to staff
- Minimizing rejections and denials
Minimize Bad Debt and Write-Offs
While there will always be patients unable to afford the full cost of medical care, having accurate information, offering upfront cost estimates to patients, and billing all responsible payers can result in higher revenue collection. With proper procedures in place, there is no longer any reason to leave services unbilled due to uncertainty about whom to bill.
Both Front-end and Billing Staff Appreciate Coverage Discovery
Both the front-end and billing staff value our services because they streamline their work processes, making them more efficient. Additionally, our services free up their time, allowing them to concentrate on tasks that demand their full attention.
Efficient Registration Process
Improving the registration process enhances staff ability to obtain accurate information, enabling them to communicate effectively with patients. When patients have a clearer understanding of their bills and financial obligations, it increases the likelihood of receiving payment. While some patients may face challenges in covering medical expenses, being informed in advance and arranging a payment schedule can boost the portion of payments collected and foster patient satisfaction with the billing process.
Qualified Billing Staff
Having accurate insurer/payer information is advantageous for the billing staff. Code matching ensures that submitted claims are approved, simplifying the filling process by identifying appropriate codes in advance.
Remote Expert Solution specializes in delivering tailored revenue cycle management services to the medical sector. Our commitment to addressing the specific requirements of each client has led to a roster of satisfied customers who reap the advantages of partnering with a comprehensive medical billing company. For inquiries, please reach out to us at 1-516-202-0546. If you’re skeptical about the possibility of increasing revenue while utilizing our coverage discovery and billing services, click here for a complimentary demo. We’re eager to demonstrate the efficacy of our approach.