Coverage Detection Solution: Detect Patient Coverage

Uncover Hidden Coverage for Patients, Increase Collections, and Reduce Bad Debt

A surprising percentage of your self-pay and charity patients likely have full or partial insurance coverage that your organization may not be aware of. ZirMed’s Coverage Detection solution provides powerful, proprietary intelligence based on a decade-and-a-half of data from hospitals, health systems, physicians, specialty groups, ancillary providers, and payers. The solution makes it easy to discover patient coverage with a fast, easy, and cost-effective approach – while delivering a superior hit rate that confirms 2.8x more coverage than the competition.

Provide Actionable Results in Minutes

ZirMed’s Coverage Detection solution delivers actionable results that clearly identify patient coverage (active and inactive) regardless of a patient’s point of entry into the system—even if the patient lacks an insurance card or other information. The solution routinely finds 5%-15% of billable insurance. The ability to detect patient coverage equates to increased collections and reduced bad debt for your organization.

Boost Revenue and Profit Margins While Lowering AR Days

ZirMed’s Coverage Detection solution helps you increase revenue and profit margins by improving collections and reducing bad debt as well as inappropriate charity write-offs. Coverage detection also reduces collection costs by automating the search for active coverage, reducing labor-intensive patient follow-up, and maximizing the percentage of revenue billed to payers. As a result, you’ll see a decrease in AR days because you detect patient coverage more quickly.

Maximize Revenue Opportunities with Newly-Insured Patients

Newly-insured patients may not carry insurance cards or even fully understand their benefits. With ZirMed’s Coverage Detection solution, you can discover patient coverage, even if the patient is unsure or unaware of their own coverage so you won’t miss out on an opportunity to capture revenue.

Improve Patient Satisfaction

By using ZirMed’s Coverage Detection solution, your organization can improve patient satisfaction. Coverage Detection not only helps discover patient coverage in instances where they weren’t aware, but it also prevents staff from trying to collect directly from patients who technically have insurance coverage and therefore should not be identified as self-pay.

Integration Capabilities

By design, ZirMed’s revenue cycle management platform enables creators of healthcare technology solutions to seamlessly and easily incorporate our HIPAA and PCI-compliant applications and transactions into your software solutions. Using ZirMed’s integration capabilities, organizations seeking a traditional approach of exchanging EDI transactions may transmit and receive a variety of claims, payments, eligibility inquiries, and other healthcare transactions using established technologies and methods such as X12 files, APIs, Flat Files, FTP, Encryption (i.e. PGP), and more. You’ll have confidence knowing that your exchanges are occurring securely, in compliance with all regulatory guidelines, and utilizing existing technological capabilities.

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