Health Insurance Discovery

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• How does health insurance discovery work?

  Health insurance discovery searches for missing or hidden patient coverage that may not appear during registration or initial eligibility verification. R1 Insurance Discovery uses AI-powered search, payer intelligence and revenue cycle expertise to identify coverage opportunities, validate billable results and return verified coverage to the EHR.

• What does coverage discovery mean?

  Coverage discovery in healthcare is the process of finding active insurance coverage that was not captured upfront, including Medicare, Medicaid, commercial, coordination of benefits (COB) and secondary coverage opportunities. It can help health systems reduce uncompensated care, prevent lost revenue and improve revenue recovery.

• Is insurance discovery the same as eligibility verification?

  No. Eligibility verification confirms known insurance information, while insurance discovery searches for missing coverage, secondary coverage or payer information that may not appear in standard real-time eligibility checks . R1 helps uncover coverage across self-pay and insured accounts where coverage may be incomplete, outdated or missed.

• Can insurance discovery help after a claim denial?

  Yes. Insurance discovery can help after a claim is denied by identifying missing coverage, COB issues or secondary payer opportunities that may support rebilling or recovery. It can also help reduce future claim denials by improving coverage data before teams bill or rebill accounts.

• How can insurance discovery improve revenue cycle management?

  Insurance discovery can improve revenue cycle management by finding missing patient coverage, prioritizing billable opportunities, reducing manual account work and helping teams recover revenue that may otherwise become uncompensated care or bad debt.

• How can insurance discovery improve patient billing processes?

  Insurance discovery can improve patient billing processes by helping health systems identify the right coverage before billing the patient. Better coverage data can reduce unnecessary patient statements, support more accurate payer billing and lower the administrative burden on billing teams.

• What should health systems look for in an insurance discovery solution?

  Health systems should look for an insurance discovery solution that searches beyond self-pay; identifies primary, secondary and tertiary coverage; reduces false positives, supports payer intelligence and helps return verified coverage to the EHR.