Finding Missing Coverage, Improving Your Bottom Line

Nemadji’s back-end Eligibility Detection solution combines the extensive knowledge of our team with advanced logic to review patient accounts for cases of missing or previously unknown eligibility across Medicare, Medicaid and commercial insurance.

We find coverage for services not found by internal processes and other vendors—and cover the cost of our solution through the revenue generated from the coverage we find. Best of all—we don’t collect from patients to achieve our results.

Is Eligibility Detection right for your hospital? We think so—and here’s why:

  • Help drive efficiencies as your staff learns from our methods and applies them to future in-house efforts
  • We work to integrate with your existing infrastructure as seamlessly as possible, helping expedite the identification of lost revenue
  • Our processes enhance existing eligibility identification efforts by picking up where you leave off—whether early in the process or with our industry-leading Last-in-Line™ review once your other vendors have exhausted all efforts

Post-Service Account Timeline

Eligibility Detection service works seamlessly with existing systems and processes to complement and enhance current efforts, at any point in the post-service timeline.

Patient

Early Backend
Eligibility Vendors

Early Out Self-Pay Vendors

Bad Debt Solutions

Denial Management

Eligibility Detection

Eligibility Detection

Eligibility Detection:

Last in Line™


Our Eligibility Detection Process

We identify a variety of inaccuracies, such as data anomalies hidden by transposed numbers, patient identification inconsistencies, coding mistakes, patient registration errors, and discrepancies in eligibility sources. Our results speak for themselves.

Our People Make the Real Difference

Our dedicated and experienced team discovers revenue that would otherwise be lost—revenue that goes straight to the bottom line.


Problem Solving Is Second Nature

With our experience, we know more and can do more for our clients—resulting in less hassle, better results and stronger solutions.

We are proud to do this work. We are proud to be Nemadji.
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