• Real-Time Insurance Discovery

Insurance Discovery

Insurance Discovery Software from eClaimStatus is a unique combination of human intelligence with 25+ years of end-to-end revenue cycle experience along with technology driven algorithm. This combination helps in finding the accurate commercial or federal active coverages that was previously unknown/ un-collected/ forgotten/ missed / withheld during patient registration.

eClaimStatus Insurance discovery goes a step forward in providing COB (Co-ordination Of Benefits) information of the patient thereby providing the complete insurance demographic information to the service providers.

Identifying the correct payor helps provider to file the claim promptly by reducing the chances of rejection or denials that may arise due to coverage/missing information. This converts to quick reimbursement for the service provided and reduces the Account Receivables.

Where can it be used?

Insurance discovery is very helpful in specialties where the specialist/ technician/ service provider does not have face to face interaction with the patient such as

  • Hospitals
  • Clinical Laboratories
  • Radiology
  • Anesthesiology
  • Emergency Rooms / Urgent Care
  • Group / Solo Practices
Where can it be used

In addition, the insurance discovery tool can be used by Charitable Organizations to identify actual financial status of the patient and determine if they are below the poverty line and if the Organization is willing to assist/ provide a waiver to the patient for the services rendered.

What do we offer:

Better Technology:

Identify an average of 30% more Insurance Coverage with the assistance of 15 algorithms that have been customized and developed with inputs from people who have more than quadrans centennial years of experience in Revenue Cycle Management.

Better Technology
AI Optimization

AI Optimization:

A fusion of artificial intelligence and machine learning helps us recognize payer’s response patterns and dynamically update algorithms to enhance insurance discovery.

Payers rules engine & Policy Library:

Access to propriety rules engine and policy library for all major payers Includes published and "Rules in Practice" based on actual payer response

Payers Rules Engine Policy Library
In Depth Search

In Depth Search:

Insurance discovery scans data from multiple streams such as Patient Demographics, Insurance Discovery, Real Time Eligibility, Federal Poverty Level, Charitable Qualifications, Historical Information, Health Payers Systems and more to provide superior coverage discovery

Nation Wide Payer Network:

With our network of 1,080+ payers, we accurately identify the billable Primary, Secondary and Tertiary Coverages for Federal and Commercial Payers

Nation Wide Payer Network
Real-Time Batch Submission

Real-Time and Batch Submission:

Insurance discovery provides the option of querying single patients in real time or creating a batch process for multiple queries.

Demographic Validation:

AI driven eClaimStatus Insurance Discovery is equipped to automatically detect, highlight, flag any data discrepancy on the demographic by comparing the payer systems and input data. This increases clean claim submission ratio which in turn has rippling effort of increasing the first pass ratio, identifying denials and addressing AR at an early stage, reducing AR days and quicker reimbursements.

Demographic Validation
Easy and Cost-Effective Implementation

Easy and Cost-Effective Implementation:

eClaimStatus Insurance discovery is a cloud based and does not require installation of any software application or hardware solutions in the work system.

Exceptional Client Support:

eClaimStatus support team offers handheld training and troubleshooting services via e-mail, voice and secure RDP connections.

Exceptional Client Support
Highlights of eClaimStatus Insurance Discovery

Highlights of eClaimStatus Insurance Discovery:

Below are some of the key highlights:

  • HIPAA Compliant
  • 1,080+ Payer Network
  • Real Time Insurance Discovery as well as Bulk Batch Option
  • Secure Portal
  • Unlimited Users
  • Excel and PDF Output to suite your needs
  • API Friendly

Information Required to run Insurance Discovery:

  • Patient Last Name & First Name
  • Patient DOB & Gender
  • Patient Address
  • DOS
Information Required to run Insurance Discovery
Information Retrieved by eClaimStatus Insurance Discovery

Information Retrieved by eClaimStatus Insurance Discovery:

  • Patient Last Name & First Name
  • Patient DOB
  • Primary Insurance Name, ID number, Group Number, coverage effective date
  • Secondary Insurance Name, ID number, Group Number, coverage effective date
  • Tertiary Insurance Name, ID number, Group Number, coverage effective date
  • And More…