maxRTE Insurance Discovery

Uncover Billable Coverage for
Up to 25% of Self-Pay Patients

Submit a Free Test File
maxrte Insurance Discovery software

The most effective way to combat uncompensated care is to find billable coverage for self-pay accounts with maxRTE Insurance Discovery.

Access payers in a single click, and learn in seconds about health insurance benefits that self-pay patients may not know they were entitled to. Our EHR integration through API or batch file transfer via SFTP makes Insurance Discovery a simple tool for verifying eligibility. Find coverage faster and speed up your revenue cycle.

Unmatched Accuracy in Discovering Hidden Coverage

Our proprietary technology locates a higher percentage of unknown commercial and exchange payer plans, workers compensation benefits, Third-party administrators (TPAs), and Cobra coverage compared to other solutions. And our ability to unearth unknown government coverage, including Medicare (MBI Lookup), Medicaid, and Tricare is unmatched.

Insurance Discovery collection rate

Unmatched Accuracy in Discovering Hidden Coverage

Our proprietary technology locates a higher percentage of unknown commercial and exchange payer plans, workers compensation benefits, Third-party administrators (TPAs), and Cobra coverage compared to other solutions. And our ability to unearth unknown government coverage, including Medicare (MBI Lookup), Medicaid, and Tricare is unmatched.

Insurance Discovery performance summary

357 Hidden Accounts. $250K Recovered.

A 300-bed facility completed an insurance test file. maxRTE Insurance Discovery found 357 billable accounts, totaling over $852,000 in total charges. The facility was able to bill after final review, resulting in more than $250,000 in remits & previously unknown revenue.

Insurance Discovery revenue recovered

maxRTE Insurance Discovery:
The Industry Leader in Uncovering Hidden Coverage

Our proprietary algorithm and deep expertise in payer filing and retro-approval periods make maxRTE’s Insurance Discovery solution the most reliable tool for finding previously unknown coverage. We consistently outperform other software solutions by identifying coverage for self-pay patients more efficiently. With value-driven pricing, our solution maximizes return on investment while ensuring that implementation is seamless and quick. We offer superior customer support, providing dedicated assistance to keep your operations running smoothly. Additionally, our solution features flexible processing options that integrate seamlessly into your existing workflows, enhancing efficiency and streamlining the revenue cycle.

maxRTE Insurance Discovery is different than other vendors.

See the maxRTE Insurance Discovery Difference for yourself.

Insurance Discovery processing

Insurance Discovery Processing

customized payer plan mapping

Customized Payer Plan Mapping

retro eligibility checks

Retro Eligibility Checks

Insurance discovery implementation

Implementation

Insurance Discovery flat fee structure

Cost

Insurance Discovery positive results

Results

Locates any unknown coverage (primary, secondary, tertiary, etc) on as much as 25% of your self-pay accounts.

How we’re different:

Our technology locates a higher percentage of unknown commercial and exchange plans compared to other solutions, in addition to unknown government coverage (including Medicare, Medicaid, Tricare).

maxRTE standard best practice:

Our knowledge of timely filing limits and retro approval periods delivers a higher ROI compared to other solutions.

Enables submission of zero balance accounts to locate primary coverage to Medicaid (helpful for Medicaid take back payments).

Insurance Discovery processing

Insurance Discovery Processing

Locates any unknown coverage (primary, secondary, tertiary, etc) on as much as 25% of your self-pay accounts.

How we’re different:

Our technology locates a higher percentage of unknown commercial and exchange plans compared to other solutions, in addition to unknown government coverage (including Medicare, Medicaid, Tricare).

maxRTE standard best practice:

Our knowledge of timely filing limits and retro approval periods delivers a higher ROI compared to other solutions.

Enables submission of zero balance accounts to locate primary coverage to Medicaid (helpful for Medicaid take back payments).

customized payer plan mapping

Customized Payer Plan Mapping

Payer mapping ensures clients have correct billing information to limit denials. Properly identifies Medicaid HMO and traditional plans, Medicare, Medicare HMO, correct commercial and exchange plan mapping aligned with your EHR.

retro eligibility checks

Retro Eligibility Checks

maxRTE standard best practice:

Our knowledge of timely filing limits and retro approval periods delivers a higher ROI compared to other solutions.

Enables submission of zero balance accounts to locate primary coverage to Medicaid (helpful for Medicaid take back payments).

Insurance discovery implementation

Implementation

With maxRTE, you won’t have to wait days, weeks, or months to start realizing the financial benefits of Insurance Discovery.

Create an account, set up your NPI number, and configure your login details. You’ll be ready to uncover hidden coverage for self-pay patients.

Insurance Discovery flat fee structure

Cost

maxRTE offers a transparent, flat-rate pricing model that eliminates the unpredictability of contingency fees, providing cost certainty and enabling scalable growth for your revenue cycle management needs.

Insurance Discovery positive results

Results

Locates any unknown coverage (primary, secondary, tertiary, etc) on as much as 25% of your self-pay accounts.

Our technology locates a higher percentage of unknown commercial and exchange plans compared to other solutions, in addition to unknown government coverage (including Medicare, Medicaid, Tricare).

Insurance Discovery ROI

Premier Health Uncovers $2.9M in the First Three Months of Leveraging Insurance Discovery from maxRTE

Project Background

Following the end of the public health emergency (PHE), Premier Health experienced an increase in self-pay patients and sought an insurance discovery solution that could identify the correct plan upfront to ensure timely reimbursement and reduce denials. With their extensive network of hospitals, medical organizations and physicians, Premier Health is one of the largest comprehensive health systems in Ohio.

Woman in rain Premier Health case study

Results

56,000

accounts processed in the first three months

50x

return on their
investment 

$2.9M

in remits from insurance discovery in three months

Receives results that are 100% customized to Premier’s payer mix, reducing their need to manually weed out non-billable discoverables

Able to run insurance discovery at multiple stages of the revenue cycle, including pre-service, day of service, and during look-back periods, ensuring comprehensive coverage verification

View Case Study

Find Billable Coverage for up to 25% of your Self Pay Population

Submit a Free Test File
Clock for implementation

Easily Installed,
Ready to Use in Hours

With maxRTE, you won’t have to wait days, weeks, or months to start gaining the financial benefits of Insurance Discovery.

Simply create an account, set up your NPI number, and configure your login details. You’ll be ready to uncover hidden coverage for self-pay patients, verify real time eligibility, or automate prior authorizations, all without lengthy delays.

maxRTE’s solutions seamlessly integrate with your existing EHR system, providing immediate access to eligibility checks without the need for time-consuming payer calls or navigating multiple portals. This streamlined process enables your staff to focus on more impactful tasks while still ensuring accurate coverage verification.

maxRTE offers comprehensive online training and ongoing support from our team of specialists during regular business hours. For urgent matters outside of business hours, including weekends and holidays, we guarantee fast response times, ensuring your team always has the help they need.

All EHR integrations, payer connections, and feature enhancements are included within your agreement and covered by our flat monthly fee, eliminating hidden costs and ensuring a predictable, scalable solution for your organization.

News from maxRTE

All News

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Healthcare Finance Execs on Edge about Possible Negative Shift in Payer Mix

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