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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 This modern approach replaces outdated manual methods of insurance discovery with a swift and thorough search that queries numerous databases in mere seconds, yielding detailed and accurate coverage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.
Description
By focusing on fewer high prices and adopting more competitive pricing strategies, we maximize the potential for generating additional net revenues. This is achieved by narrowing or eliminating the discrepancies between charges and negotiated rates for contracts that feature "lesser of" clauses. Furthermore, we bolster net revenues through the identification and recovery of underpayments. Each client benefits from our tailored models, as we avoid pigeonholing their data into a one-size-fits-all software solution. Our bespoke models yield high accuracy since we meticulously analyze every contract, model all relevant terms, verify the correspondence between plan codes and insurance products, and conduct rigorous tests on our models. We take into account every reimbursement affected by price alterations, which leads to the most precise predictions in the industry. Additionally, we offer a pricing methodology that is not only defensible but also clear and understandable for patients, ensuring that our pricing structures are logical and appropriately tiered. Ultimately, our approach leads to enhanced revenue generation while maintaining transparency and fairness in pricing.
API Access
Has API
API Access
Has API
Integrations
Inovalon Provider Cloud
Pricing Details
No price information available.
Free Trial
Free Version
Pricing Details
No price information available.
Free Trial
Free Version
Deployment
Web-Based
On-Premises
iPhone App
iPad App
Android App
Windows
Mac
Linux
Chromebook
Deployment
Web-Based
On-Premises
iPhone App
iPad App
Android App
Windows
Mac
Linux
Chromebook
Customer Support
Business Hours
Live Rep (24/7)
Online Support
Customer Support
Business Hours
Live Rep (24/7)
Online Support
Types of Training
Training Docs
Webinars
Live Training (Online)
In Person
Types of Training
Training Docs
Webinars
Live Training (Online)
In Person
Vendor Details
Company Name
Inovalon
Founded
1998
Country
United States
Website
www.inovalon.com/products/provider-cloud/patient-access/insurance-coverage-discovery/
Vendor Details
Company Name
Sophical Solutions
Country
United States
Website
www.sophicalsolutions.com
Product Features
Payment Processing
ACH Check Transactions
Bitcoin Compatible
Debit Card Support
Gift Card Management
Mobile Payments
Online Payments
POS Transactions
Receipt Printing
Recurring Billing
Signature Capture