Eligibility Detection

Finding Missing Coverage, Improving Your Bottom Line

Nemadji’s back-end Eligibility Detection solution finds coverage for services not found by internal processes and other vendors. By continuously screening accounts for eligibility, we are able to identify and verify previously unknown, billable coverage.
67% of our clients saw over $1M in net new revenue in the past 12 months.

Maximum Flexibility

Eligibility Detection works seamlessly with existing systems and processes to enhance current efforts at any point in the post-service timeline.
We work to integrate with your existing infrastructure, helping expedite the identification of lost revenue by augmenting your workforce.

We Know Our Niche

Nemadji’s processes enhance existing eligibility identification efforts by picking up where you leave off with our industry-leading Last-in-Line™ review.
74% of our clients utilize Eligibility Detection in support of existing back-end processes.

Looking
Ahead

Help drive efficiencies as your staff learns from our methods and applies them to future in-house efforts.
Actionable data is provided to our clients in the form of Cause Reports, pinpointing not only where we found coverage, but why it wasn’t discovered previously.

Don't Take Our Word For It

“Nemadji helped identify those self-pay dollars and accounts that should in fact, not be self-pay accounts.”

Read the Case Study

How We Help

  • Reduce bad debt turnover by identifying insurance which may have otherwise been overlooked and deemed uncollectible
  • Identify accounts inappropriately categorized as self-pay
  • Reduce Bad Debt A/R
  • Reduce self-pay days in A/R
  • Increase Net Collection Rate
  • Increase Medicaid IP days identified to achieve/maintain DSH and/or 340B eligibility

 

  • Increase Revenue
  • Increase Patient Satisfaction
  • Reduce Cost and Volumes passed to Early Out
  • Reduce Uncompensated Care volumes

How Much Revenue Are You Missing?

Let us focus on finding your missing revenue so you can focus on what matters most—caring for patients.

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