INFOGRAPHIC
5 Ways to Find More
Billable Coverage for
Self‑Pay Accounts
Uncompensated care is on the rise, projected to cut hospital revenue by $87 billion between 2025 and 2034.1,2
Inovalon helps providers avoid downstream denials and rejections by identifying all available coverage with confidence. Inovalon’s Insurance Discovery™ returns an average insurance identification hit rate of 43.04% on uninsured accounts.3
Here are five ways Insurance Discovery can help you find more billable coverage for self-pay accounts:
Verify Demographics
Verify nine key elements in real time, including patient name, address, date of birth, phone number, and Social Security number. Find any missing data points and quickly obtain complete, accurate information for each patient and claim.
Find All Active Coverage
Identify primary, secondary, and tertiary coverage with a single tool. Rank payer coverage, identify managed care and advantage replacement plans, and list relevant plan types (HMO, PPO, etc.).
Expand Your Payer Search
Gain a complete view of applicable coverage with allpayer search capabilities. Find up to double the number of payers compared to other services by running an average of 13 transactions per patient.
Search Geographically
Query the most probable payers for each individual patient covering all 50 states and U.S. territories.
Customize Workflows
Make work easier with custom rules based on facility, patient, state, and payer. Eliminate false coverage with custom exclusions and automatically retry verification at set intervals if payer network is inaccessible.
The Toll of
Uncompensated Care
63%
Of healthcare leaders say unknown patient insurance information is a significant challenge.5
67%
Of healthcare leaders point to front-end issues like insurance discovery as a top cause of claims denials.5
$695 million
In potential revenue is left on the table due to missing or inaccurate benefits details.5
Boost Reimbursements by Finding All Active Coverage Up Front
Avoid claims denials by billing the right payer the first time and provide a better care experience for patients by reducing the stress of surprise bills.
- “Rural Hospital Revenue Could Drop by $87 Billion over 10 Years Because of the Reconciliation Bill and Expiring Enhanced Tax Credits,” Fredric Blavin, Michael Simpson, Laura Skopec, Urban Institute, June 30, 2025, https://www.urban.org/urban-wire/rural-hospital-revenue-could-drop-87-billion-over-10-years-because-reconciliation-bill
- “American Hospital Association launches ‘seven-figure’ ad campaign against Medicaid cuts,” Dave Muoio, Fierce Healthcare, June 24, 2025, https://www.fiercehealthcare.com/ providers/american-hospital-association-launches-seven-figure-ad-campaign-against-medicaid-cuts
- Internal reporting, Inovalon, March 4, 2025. Individual results may vary.
- Average of customer results. Inovalon internal reporting, July 30 2024.
- “Claims Denials: Causes, Impact, and AI-Enabled Prevention Strategies,” Inovalon, October 2024, https://www.inovalon.com/resource/claims-denials-causes-impact-and-aienabled-prevention-strategies/
Inovalon and design® and Inovalon® are trademarks of Inovalon, Inc.
