Eliminate coverage gaps to maximize reimbursements. Nexus io’s coverage discovery services identify active insurance for uninsured or self-pay patients enabling faster authorizations and cleaner claims. Integrated with your EHR and practice management systems, we help you maximize reimbursements and reduce patient surprises. Maximize patient care by maximizing coverage discovery.
Collection Ratio
First Pass Clean Claim Rate
Reduction in A/R
Accurate coverage insights are essential for healthcare practices including hospitals, clinics, physician practices, and specialists to prevent denials and billing surprises. Yet hidden benefit limits and preauthorization requirements often drain administrative resources, frustrate patients with “Surprise Bills”, and delay reimbursements.
Without a clear view of plan specifics, healthcare practices spend countless hours investigating benefits and appealing denials.
With coverage discovery services, Nexus io identifies patient benefits, co-pays, and prior authorization rules before appointments. We identify coverage gaps, secure authorizations, verify eligibility, and ensure claims submit cleanly for faster payment.
Insurance discovery is an important step in a healthcare revenue cycle management. Accurate coverage information prevents denials, reduces surprise patient balances, and keeps healthcare practices billing on track. Some of the key insurance discovery challenges are:
We uncover coverage details across every payer like Medicare, Medicaid, VA programs, commercial insurers, and private plans; so no benefit goes unnoticed. Our discovery health insurance services ensure healthcare practices secure authorizations, map patient liabilities, and fast-track reimbursements across all government and private payers.
With coverage discovery, Nexus IO targets payers for each patient and validates enrollment, copayments, and prior authorization requirements at each level. We do real-time eligibility verification and coordinate the claims in proper sequence per CMS rules, so each insurer pays its share before any patient billing is done.
This system takes up EOB processing and claim adjudications efficiently across Medicare, Medicaid, commercial insurance, and employer-sponsored plans. Such in-depth Coordination of Benefits (COB) greatly reduces denials and patient responsibility and definitely maximizes reimbursements while almost eliminating patient surprises.
Through revenue discovery and optimization, Nexus io performs specialized Medicare & Medicaid eligibility checks, enrollment status, benefit periods, and state-specific requirements. We confirm each patient’s MBI, plan details, and program limits up front to prevent denials and ensure seamless claims processing. Our proactive verification process ensures you secure every dollar available from government insurance payers..
Nexus io’s insurance discovery services pinpoint active primary, secondary, and tertiary coverage along with Medicare Beneficiary Identifiers (MBIs) and patient demographics in one efficient inquiry. When paired with thorough eligibility verification, our streamlined approach boosts staff productivity and delivers more accurate coverage outcomes. Choose Nexus io for:
Let us handle the coverage details, so you can focus on delivering exceptional patient care.
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Coverage discovery begins at the very start of the medical revenue cycle with patient insurance eligibility verification. Nearly one-third of claim denials and rejections stem from unverified coverage and missing prior authorization requirements. If coverage surprises are jeopardizing your claims, it’s time to partner with a revenue discovery systems expert. Nexus io’s revenue discovery systems automate eligibility checks and benefit mapping from day one.
Coverage complexities and manual payer research often leave coverage gaps; unpaid services can escalate into bad debt (outstanding patient balances) or write-offs (uncollectible claims removed from your ledger).
Nexus io, professional coverage discovery services, uncover these gaps with advanced technologies to locate all available coverage, including difficult-to-locate billable coverage. We use intelligent verification for all possible search combinations for each private, government, and state-specific insurance payer, including retrieval of Medicare Beneficiary Identifiers (MBIs) to eliminate eligibility mismatches.
By outsourcing your medical billing to a trusted partner like Nexus io, you free your front office from time-consuming eligibility checks and paperwork. Our experienced billing team verifies patient coverage, manages benefits, and identifies pre-authorization requirements to ensure accurate claims submission. This combination of expert oversight and efficient processes reduces errors and denials, allowing your staff to focus more on patient care rather than insurance paperwork.
Our achievements are a testament to our hard work team to deliver exceptional revenue boost results and gain the client’s trust in us.
Can Nexus io’s revenue discovery system integrate with our EHR or PMS?
Yes. Our revenue discovery system uses secure, standards-based APIs to connect with all major EHR and PMS platforms. With bi-directional data flows, patient demographics, coverage details, and claim statuses sync automatically. Our seamless integration keeps your front-desk and billing teams perfectly aligned.
What types of providers benefit most from coverage discovery services?
Nexus io, coverage discovery services, is invaluable for any high-volume or specialty practice like: ambulatory surgery centers, radiology groups, cardiology clinics, multi-site physician networks, and FQHCs all see major gains. Even we help small private practices to eliminate denials and upfront revenue leaks by locking in benefits before care.
How quickly can providers see results with Nexus io’s coverage discovery?
Many clients notice fewer denials and better upfront collections within the first two weeks of implementation. By the end of the first billing cycle, most practices report measurable improvements in days in A/R and fewer surprise patient balances.
Is Nexus io’s coverage discovery service HIPAA-compliant?
Absolutely. Nexus io encrypts PHI in transit and at rest, operates under a signed Business Associate Agreement, and undergoes regular HIPAA audits and penetration tests to ensure 100% compliance and data security.
What reporting and analytics does Nexus io provide with its coverage discovery services?
Nexus io delivers interactive dashboards and automated reports that highlight coverage gaps, pre-auth trends, and eligibility exceptions. You get real-time visibility into potential denials, patient liability forecasts, and weekly performance summaries to empower informed decisions and proactive revenue discovery.
Nexus io place the utmost priority on our patient privacy, we ensure that our healthcare revenue cycle management services fully comply with HIPAA regulations; to protect patient’s data with strong security measures:
By outsourcing your coverage discovery services to Nexus io, you will experience a more stable and predictable cash flow for all your services rendered with up-to-date patient insurance data. Fill out the short form, and an insurance discovery expert from our team will contact with you instantly.
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