Insurance Discovery

Find active insurance coverage

Higher deductibles, bigger patient co-pays and evolving Medicaid programs have created new sources of bad debt for healthcare providers. Financially clearing self-pay patients is more challenging and labor-intensive than ever before. Most important, earned revenue walks out the door every day when patients leave the office without paying and patient A/R is written off as bad debt.

Payor Logic’s Insurance Discovery service combines innovative technology with human intelligence to explore every coverage option and payor source for patients presenting as self-pay. Our customers report remarkable results:

  • Identify active coverage for more than 10 percent of self-pay accounts
  • Maximize revenue by tapping other payor coverage opportunities
  • Reduce overall self-pay A/R

How it Works

Insurance Discovery software interrogates multiple data sources seeking coverage for your self-pay patients. Insurance verification experts at Payor Logic use the latest mapping logic for more than 2,000 payors, clearinghouse databases and direct connections infrastructure to find more active coverage, including commercial sources.

The Results

Payor Logic examines claims and clearinghouses at multiple levels to uncover every possible payor source. At one client location, Payor Logic identified insurance coverage for 16 percent of all patients and more than $800,000 in coverage for patients who originally presented as self-pay.

5 unique ways our clients find 29% more billable coverage View infographic ⨠

“We don’t have time to waste on digging for coverage. Payor Logic drills down deeper and more effectively—they save us time and find us money.” Upstate New York EMS Provider