Eligibility Detection
Strengthen Your Bottom Line with Every Patient FileFinding Missing Coverage, Improving Your Bottom Line
Ensure adequate payments for your hospital with Nemadji's back-end insurance discovery solution, Eligibility Detection. Eligibility Detection acts as a safety net without impacting your existing processes.We Know Our Niche
With our industry leading Last-in-Line ™ approach, we have 40 years of experience in finding revenue that others have missed. On average, we find upwards of half a million dollars a month following other vendors.Last-in-Line ™
Eligibility Detection integrates smoothly with your existing systems—whether you're using custom tools, a solution built into your EHR, manual processes or other vendors. We've designed our process to deliver measurable outcomes without requiring big teams or complicated tech transitions. We adapt to your process to strengthen what's already in place. The result? Identification of missed coverage without adding extra administrative burden to your team.Consistent Results
We're more than a one-time boost, we're a sustainable strategy. By continuously screening accounts over time, we identify and verify previously unknown, billable insurance coverage as it presents itself. Our proactive approach ensures that as the healthcare landscape evolves, your recovery efforts don't fall behind.Don't Take Our Word For It
Nemadji helps identify those self-pay dollars and accounts that should in fact, not be self-pay accounts.Industry Leading AccuracyHow It Works
No matter how diligent your processes, things still slip through the cracks. Often, providers aren't aware of what they're missing out on. A partnership with Nemadji helps optimize existing back-end revenue cycle processes to improve reimbursement rates, increase staff efficiency, boost cash flow and enhance patient satisfaction. Our systems are built on a unique combination of technology and experience-based knowledge that's been developed over four decades of solving complex revenue cycle obstacles. We're problem solvers.01
Eligibility Review
We combine our homegrown technology + expert analysts to review all types of accounts for missing or unknown insurance eligibility.02
We Don't Stop There
Our continuous review processes allows us to identify opportunities for coverage up to—and sometimes exceeding—payer timely filing limits, utilizing new data as it's received. In many cases, patients qualify for retroactive coverage that was impossible to detect earlier in the process. Not only do we detect primary and secondary coverage, we'll correct payer order to ensure compliance with Coordination of Benefits rules. We've got your back.03
Full Transparency + Advanced Analytics
Our findings are delivered to you monthly in an easy to digest format that includes our highly-valued Cause Reports. Our unprecedented net invoicing structure saves our clients 15% annually over other vendors.04
We Pay For Ourselves
In true partnership form, we don't get paid until you get paid. As a contingency offering, there are no up front costs for your organization.
How We Help
Hospitals have multiple processes in place throughout all stages of the revenue cycle to identify insurance coverage. As a result of partnering with Nemadji, you can expect:
A reduction in bad debt turnover, by identifying insurance which may have otherwise been overlooked and deemed uncollectable.
An increase in identification of Medicaid IP days—which are critical in maintaining/obtaining DSH and 240B eligibility.
Correction of accounts inappropriately categorized as self-pay.
A reduction in Bad Debt A/R, cost and volumes passed to Early Out, and uncompensated care volumes.
Reduce self-pay days in A/R
Increased revenue, patient satisfaction and net collection rate.