Insurance Discovery moves into the modern era
R1 rethought Insurance Discovery from scratch – leveraging modern technology and deep experience to find all available coverage, eliminate false-positive results that aren’t billable and return valuable findings to the EHR.
At the heart of R1 Insurance Discovery is a search engine, powered by R1’s Phare OS™ revenue operating system, tailored to deliver optimal coverage for each health system. Insurance Discovery factors region, payer mix and variations in patient data to improve accuracy and reduce false positives. For example, the solution can identify missed coverage even when a patient provides a nickname instead of their full name.
What sets R1 Insurance Discovery apart is how it validates findings and then returns the coverage directly to the customer’s EHR. Intelligent search ensures quality, filtering out false-positive results so you only see billable coverage that will produce revenue. Then, this verified coverage loads automatically to the EHR, eliminating spreadsheets and manual entry and freeing your staff for higher revenue activities.
From the start, this product was built with the nation’s largest health systems, so it goes beyond self-pay to find missing coverage on all Medicaid, Medicare and commercial accounts, including valuable COB accounts, retroactive Medicaid monitoring and secondary coverage.
R1 Insurance Discovery is changing the way health systems recover revenue for missing insurance.
Three top health systems representing >$25B in NPR are already running the product. Consistently, customers are seeing recoveries grow by more than 10% annually compared to incumbent solutions, totaling more than $150M in recoveries since launch, and the results are only expected to get better.
