Insurance Discovery Post-Service

Discover coverage for denied claims due to missing insurance details.

INSURANCE DISCOVERY PRE-SERVICE MODULE

Discover Missing Insurance Details Prior To Care With AI

Our patient access platform not only allows you to verify insurance coverage and benefits in real-time; it also is able to discover coverage that the patient may not even be aware exists.

  • Missing, invalid primary and secondary insurance
  • Uninsured, charity care and undisclosed by patients
  • DNFB, missing patient demographics, CH rejections

Reduce staff time spending hours on the phone or manually navigating payer portals trying to verify incomplete, inaccurate, or expired benefits, as well the risk of write-offs downstream due to missing insurance denials which ultimately impact reimbursement for service delivered.

POWERED BY AI, INTEGRATIONS & ADVANCED ANALYTICS

How Our Technology Uncovers Hidden Details

Input simple fields like patient's name, date of birth, date of service, payer name, patient subscriber ID, and the provider's NPI to find coverage. You can also add service type to obtain service level benefits.

RPA Bots Mine For Data

Undisclosed coverage is deep mined from an expansive network of clearinghouses, direct payer connections, and is supplemented through a network of public and private databases.

AI & Analytics Predict, Identify And Verify

Using probabilistic analytics and machine learning, patient demographic information, insurance profiles, and coverage benefits are identified and verified.

RPA Bots Communicate Back To Your EMR

Once previously unidentified coverage is communicated back to your EMR system and is now available to your front desk staff.

REDUCE SELF-PAY ACCOUNTS

Mitigate Risk Of Non-Payment By Self-Pay Accounts

With a rising self-pay population, it’s not uncommon to mark patients whose eligibility could not be determined as self-pay. Avoid marking patients as self-pay during when they don’t have their details at time of scheduling by automatically searching for missing coverage details.

Help patients find benefits due to them

Once insurance is discovered, payer details, patient benefits and out-of-pocket payment estimates are displayed in the same dashboard so your staff can inform their patients and collect when required.

Reduce write-offs of uncollectible self-pay accounts

Confirming this data during patient registration results in increased reimbursements downstream because self-pay accounts can now be converted to claims that can be submitted to their insurance.

Avoid making patients unhappy with surprise bills

Patient experience, as well as employee satisfaction, also improves when you can avoid sending patients unexpected bills post-care because patient financial obligations can now be clearly disclosed prior to care.

Millions of Payments Reimbursed From Discovered Insurance

40%

coverage discovered for self-pay accounts

XXX

insurance discovery queries processed annually

XX

more revenue collected from discovered insurance

Compatible With Most EMRs

We offer bi-directional integration with most EHR/EMR/LIS/RIS with API, HL7, FHIR, X12 or EMR developer programs so that your staff can submit and update financial verification requests from your local system Here are some of the systems we integrate or are compatible with.

Infinx - Partner - athenahealth
eClincalWorks

Case studies

How We Help Our Clients

Learn how we work with our clients solve their pre-service and post-service insurance discovery challenges.

National Radiology Group Collects Over $1 Million In Revenue Using AI-Powered Insurance Discovery

An increasing amount of revenue owed to a national radiology group was falling into the self-pay, uncollectible, and charity care categories. As a result, uncompensated care rose significantly by more than 29%, and their uninsured self-pay and charity care accounts totaled $2.4M. Having exhausted their traditional methods of recovery, these amounts were planned to be written off as bad debt. See how our solution was able to help.

Faq

You Asked, We Answered

Curious if our solutions will meet your needs? Here are the most common questions your peers ask when evaluating our insurance discovery module in our patient access solutions.

We need the patient's name, date of birth, date of service, payer name, patient subscriber ID, and the provider's NPI to find coverage.

You can also add service type to obtain service level benefits.

Select Insurance Discovery in the dropdown menu under Product Type. This will show you cases where insurance details were found.

If you are integrating our solution with your EMR, the information is added to the patient's chart.

Our insurance discovery module in our patient access solution helps your staff discover any other insurance a patient has and avoid unnecessary bills downstream.

When you are logged in, click on a case and open the summary view. You will see a tab next to "Active Procedure" called "Insurance Discovery". This tab will show you the new-found coverage along with all the available eligibility and benefits details.

If you are integrating our solution with your EMR, the information is added to the patient's chart.

No. This capability is available by default with our eligibility verification and benefits confirmation module in our Patient Access and Patient Access Plus solutions.
We integrate with most EMR, EHR, and PMS's through APIs or HL7. Schedule a demo to learn if we integrate with the specific system your organization uses.

We are able to verify if the patient has active insurance coverage. After verifying eligibility, we check to confirm the specific service is covered and provide you the benefits at the plan level, including deductibles, stop loss, copays, and co-insurance.

We currently support the following specialties - radiology, orthopedics, laboratory and pathology, cardiology, PT/OT, pain management, and oncology. Please select Who We Help in our website’s navigation to learn more about how we support specific specialties with their patient access workflows. Feel free to schedule a demo to learn more from one our solutions experts.
We connect to over 1100+ national and regional payers.

Our solution allows you to select a place of service. You can choose from a facility, physician's office, specialist, or home visit, and we'll obtain benefits for that setting.

The list of services for which you'll receive benefits information is listed below:

  • Medical Care
  • Surgical
  • Consultation
  • Diagnostic X-ray
  • Diagnostic Lab
  • MRI/CAT Scan
  • Pathology
  • Emergency Services
  • Urgent Care

EDUCATION

Helpful Resources For Your Team

We create educational materials frequently in the form of blog posts, white papers, webinars and podcast episodes which help our clients and peers with common patient access and revenue cycle challenges they face. If you would like us to address a specific topic, feel free to reach out to us. Here are some examples.

Infinx - Webinar - How Insurance Discovery Can Dramatically Reduce Self-Pay Bad Debt with Infinx Senior Product Manager Bimal Sahoo

WEBINAR

How Insurance Discovery Can Dramatically Reduce Self-Pay Bad Debt

Article

Can Hospitals Succeed in Today’s Market with Robust Insurance Discovery Support?

Article

How Can Insurance Discovery Improve Your A/R

Reviews

Our Clients Grow With Us

As we streamline their organization’s patient access workflows, clients are happy with increased results, as well as improved cash flow due to increase in reimbursements and reduction of claim denials due to eligibility. They usually end up retaining us for other revenue cycle management tasks.

“As the entire world has been struggling through the COVID 19 staffing issues, Infinx has been an extension of our office, helping us with the most difficult insurance payors to make sure our patients have the services they need. Not only do they go above and beyond, they understand a patient with real issues is attached to that authorization request. The entire team is transparent, communicative, and is a true team…

We count ourselves lucky to have started a ‘partnership’ with the Infinx team and look forward to future solutions as well.”

Orthopedic Surgical Authorizations Specialist
Orthopedic Group in Michigan

"We have been working with Infinx for nearly a decade and they have been a wonderful partner.  We have had normal challenges, like fluctuation in work volumes, industry changes, and the complicated demands of implementing new technologies. Through it all, Infinx has been responsive, reliable and great to work with.  We look forward to many more years ahead working together.”

Director of Pharmacy Operations
Pharmacy Group in Illinois

“Your team is so dedicated, accountable and never hesitates to adjust schedules and go above and beyond, each and every day. We appreciate the flexibility you are able to provide when priorities suddenly shift and you are able to change gears with us. An important piece that has made this venture a success is communication - again your team communicate with us on a daily basis…There is never a hesitation to reach out with questions or for further clarification… We truly think of our team from Infinx as a successful extension of us. It is a pleasure to work with you all.”

Director of Reimbursement Operations
National Radiology Group

Need To Uncover Missing Insurance Details While Verifying Patient Eligibility?

Schedule a demo to learn how our AI-powered patient access solution with insurance discovery module can help your organization get more patients financially cleared prior to care.