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features
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Description

CareCost Estimate provides a solution for infusion centers and specialized medical practices to address a common patient query: what will the treatment cost? By selecting the medication, dosage, and insurance details, staff can utilize CareCost to swiftly determine the patient's out-of-pocket expense, typically within a 90-second timeframe. This calculation considers various factors such as Medicare Part B coinsurance, any applicable secondary insurance, Medigap, weight-based dosing, and potential vial waste (JW/JZ). Furthermore, it incorporates any manufacturer copay assistance programs and foundation grants the patient may be eligible for, ensuring that the figure presented reflects the actual financial responsibility of the patient. In addition to cost estimates, the platform provides insights into the prerequisites set by payers, including necessary prior authorizations, step therapy protocols, and site-of-care stipulations, all directly sourced from the payer's policy along with relevant links for reference. The pricing information is derived from the CMS Average Sales Price files, which are refreshed quarterly, and since the estimates are processed directly in the browser, patient data remains secure and does not get transmitted to external servers. Moreover, CareCost also offers complimentary resources related to billing and coding, including infusion CPT codes, J-codes, and modifiers, along with a quarterly Infusion Reimbursement Index to assist healthcare providers further.

Description

Insurance Discovery enhances financial outcomes by uncovering previously unrecognized billable coverage that providers may not be aware of, thereby minimizing underpayments and uncompensated care. By employing advanced search functionalities, this solution reveals instances where patients possess multiple active payers, which can significantly improve reimbursement prospects. Additionally, it helps to prevent delays in reimbursement and accelerates revenue collection by ensuring that claims are submitted to the correct payers on the first attempt, thanks to more precise coverage details. When utilized with verified demographic information, Insurance Discovery provides reliable coverage and eligibility insights. This modern approach replaces outdated manual methods of insurance discovery with a swift and thorough search that queries numerous databases in mere seconds, yielding detailed and accurate coverage information. Furthermore, it enhances the overall experience for patients and residents by facilitating accurate estimates of out-of-pocket expenses, ultimately contributing to a more favorable financial journey for them. By streamlining these processes, providers can focus more on patient care rather than administrative tasks.

API Access

Has API No 

API Access

Has API No 

Screenshots View All

No images available

Screenshots View All

Integrations

Inovalon Provider Cloud No 

Integrations

Inovalon Provider Cloud Yes 

Pricing Details

$189/month (first seat), $89/m
Free Trial Yes 
Free Version No 

Pricing Details

No price information available.
Free Trial No 
Free Version No 

Deployment

Web-Based Yes 
On-Premises No 
iPhone App No 
iPad App No 
Android App No 
Windows No 
Mac No 
Linux No 
Chromebook No 

Deployment

Web-Based Yes 
On-Premises No 
iPhone App No 
iPad App No 
Android App No 
Windows No 
Mac No 
Linux No 
Chromebook No 

Customer Support

Business Hours No 
Live Rep (24/7) No 
Online Support Yes 

Customer Support

Business Hours Yes 
Live Rep (24/7) No 
Online Support Yes 

Types of Training

Training Docs Yes 
Webinars No 
Live Training (Online) No 
In Person No 

Types of Training

Training Docs Yes 
Webinars Yes 
Live Training (Online) Yes 
In Person Yes 

Vendor Details

Company Name

CareCost

Founded

2026

Country

United States

Website

carecostestimate.com

Vendor Details

Company Name

Inovalon

Founded

1998

Country

United States

Website

www.inovalon.com/products/provider-cloud/patient-access/insurance-coverage-discovery/

Product Features

Medical Billing

Claims Processing No 
Claims Scrubbing No 
Code & Charge Entry No 
Compliance Tracking No 
Customizable Dashboard No 
Dunning Management No 
Invoice History No 
Patient Eligibility Checks No 
Practice Management No 
Quotes/Estimates No 
Remittance Advice No 

Alternatives

No Alternatives

Alternatives

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Veritable

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