Healthcare Revenue Cycle Management Services: Uncover Missed Insurance with eInsights
Stop Losing Millions to Missed Insurance—eInsights Recovers Revenue Without Disruption
- 96% Client Satisfaction Rating in 2025 KLAS Report
- 100% of Clients Reported Positive ROI within 90 Days
- 95.8 Rating in Insurance Discovery Category
What We Offer: Advanced Healthcare Revenue Cycle Management Services
At eInsights, we deliver customized healthcare solutions that integrate with hospital systems to uncover revenue that’s typically missed during front-end registrations and eligibility processes. Our healthcare revenue cycle management services are designed to identify unknown coverage post-service—bringing immediate, measurable results. Explore our examples of successful revenue cycle management in hospitals and learn how to integrate new healthcare solutions seamlessly with no disruption to staff.
Healthcare revenue cycle management services optimize the financial processes of hospitals and healthcare providers—from patient registration through claims processing and payment collection. While most providers focus on front-end verification, up to 10% of billable insurance is missed during initial intake, leading to unnecessary write-offs and lost revenue.
eInsights specializes in post-service insurance discovery—finding the coverage other vendors miss after traditional processes have already occurred.
Our core approach is simple: We review every patient account to find billable insurance the provider is unaware of, regardless of account status, turning what would become bad debt or charity care into collected revenue.
“eInsights found coverage on accounts we had already written off as uncompensated care. In our first quarter alone, they helped us recover $2.8M in revenue with zero workflow disruption.”
— Revenue Cycle Director, 350-bed Hospital, experiencing immediate financial benefits.
Service Overview: Customized Healthcare Revenue Cycle Management Services
eInsights delivers advanced healthcare revenue cycle management services that go beyond traditional approaches. We identify missed insurance coverage opportunities after service delivery – a critical gap in most hospital revenue cycles. Our solution ensures seamless integration with hospital systems, requiring no additional work from your staff.
Our Customized Healthcare Solutions Include:
Post-Service Insurance Discovery
Our proprietary technology identifies previously unknown insurance coverage after traditional eligibility verification and coverage discovery have already occurred.
Retroactive Medicaid Identification
We continually search for Medicaid on all accounts to capture retroactively certified coverage.
Secondary Coverage Identification
We find additional coverage when primary insurance doesn’t cover the full cost or when there is a value that can be captured on the cost report.
Coordination of Benefits Optimization
We search all Medicaid primary accounts for commercial or Medicare coverage that should be billed as primary and ensure the proper billing sequence for patients with multiple coverage types.
COB, Eligibility, and Past Timely Denial Prevention
We proactively identify and address potential reimbursement obstacles.
DSH and Dual Eligible Medicare Bad Debt
We increase cost report reimbursement by identifying unknown Medicaid on Inpatient stays and Medicaid secondary to Medicare. Any additional cost report reimbursement received as a result of this newly discovered Medicaid coverage is delivered Free of Charge.
Unlike conventional coverage discovery and eligibility tools that work before or during service and in a batch-in, batch-out model, our solution continually runs in the background, analyzing every patient account thru the revenue cycle continuum. This ensures we can capture billable coverage and prevent bad debt or charity write-offs.
WHAT OUR CLIENTS SAY:
KLAS-VERIFIED FEEDBACK
Don’t just take our word for it. See what healthcare systems like yours are saying about the transformative power of eInsights’ innovative healthcare technology solutions:
Implementation Excellence
“This has been one of our better implementations. The vendor delivered exactly as promised, and implementation took only 27 days with minimal IT resources required. Their implementation team is incredibly competent with go-lives.”
— VP/Other Executive, Healthcare System
Proven Results
“Eligibility Integrity helps us locate missing insurance and demographic information that we couldn’t find ourselves. This has helped our bottom line tremendously. In our first test file, they found coverage on accounts we had already exhaustively worked.”
— Director, Hospital
Superior Service
“eInsights is very quick to get us the information we need. Everybody I’ve worked with has responded quickly. If they see our accounts are piling up, they proactively ask whether everything is okay. Their support team is very responsive.”
— Analyst/Coordinator, Healthcare Provider
Financial Impact
“We had accounts previously self-pay or zero-pay accounts where eInsights discovered billable insurance. We saw outcomes within the first month after implementation, and it has significantly improved our revenue.”
— Analyst/Coordinator, Healthcare Provider
Accurate Coverage Discovery
“Their key strengths are accuracy and flexibility. If they aren’t confident in something, they tell us it has a low confidence level and why. They give us details on things that may not match so we can make educated decisions.”
— Director, Hospital
Long-Term Value
“The system found 31% of our self-pay accounts had billable insurance that was missed during intake. I would buy Eligibility Integrity again. I see instant results from it—I get claims filed, and payors pay the claims quickly.”
— Manager, Healthcare System
Our No-Risk, No-Obligation Approach
Comprehensive Solutions That Prove Value First
We understand that every hospital faces unique revenue cycle challenges, and integration with hospital systems is critical. That’s why we let you experience results before you commit to a contract.
Our Try-Before-You-Buy process:
Execute BAA and POC Letter
We sign your BAA to ensure HIPAA compliance and outline the risk-free terms of the proof of concept
POC Kick-off Call
We ensure alignment with all stakeholders on scope and deliverables, providing a high-level overview and assigning tasks
Data Requirements
We receive one full year of discharges and provide file specs and pre-built scripts to assist with pulling the data files needed
Optimization of Results
We apply your hospital-specific billing rules and timely filing deadlines and cull out non-billable coverages
Cash Reveal
We deliver an executive summary and reports showing the POC results along with all billable coverage your team and vendors are unaware of
Collect Your Cash
You bill the found coverages and collect the cash before timely filing deadlines. At this point, you decide whether to continue the service.
To Sign or Not to Sign
If you see value in the POC, sign the contract and begin receiving unknown coverages daily. If not, keep all the reports and recover cash with no obligation.
How to Integrate New Healthcare Solutions Seamlessly with eInsights
Seamless integration shouldn’t mean more work for your hospital—that’s why our hospital insurance discovery solution fits your existing systems perfectly. Rated 8.6 for supporting integration goals by KLAS Research in 2025, eInsights works quietly in the background, recovering revenue without disrupting your workflows.
Success Story:
Immediate Financial Impact
A community hospital struggled to identify billable insurance despite robust front-end processes. With eInsights’ hospital insurance discovery solution, they saw results within a month, turning zero-pay accounts into billable claims. A manager shared with KLAS researchers, ‘We began to see outcomes almost immediately using Eligibility Integrity, highlighting the rapid impact of our seamless go-live procedures.’
As the Director of Revenue Integrity noted, ‘Eligibility Integrity helps us locate missing insurance and demographic information, and it is absolutely meeting our expectations. Also, eInsights downloads into our system themselves, so we don’t have to do that, and that is wonderful. I’m very pleased with the product, and it has found a lot of insurances for us that we weren’t able to find ourselves. That has helped our bottom line tremendously.”
Case Studies: Examples of Successful Revenue Cycle Management in Hospitals
The Hidden Revenue Challenge in Healthcare
For years, healthcare providers have been at the mercy of patients to inform them of insurance coverage. While most patients carry their insurance cards and properly notify providers of their active coverage, some patients may not have this information available at the point of service, and efforts to collect it afterward are sometimes fruitless.
This leads to a significant problem: revenue that has been earned but remains uncollected due to missing insurance information.
Ready to Stop Leaving Money on the Table?
Discover how our unmatched insurance discovery services can transform your hospital’s financial performance without disrupting your operations.
How We Compare:
KLAS Performance Metrics
According to the 2025 KLAS Insurance Discovery Solutions Report, eInsights Eligibility Integrity consistently outperforms industry averages:
| Performance Metric | Eligibility Integrity | Segment Average | Software Average |
|---|---|---|---|
| Overall Score | 95.8 | 90.2 | 80.6 |
| Implementation Quality | 8.6/10 | 8.1/10 | 7.3/10 |
| Support Quality | 8.4/10 | 8.3/10 | 7.3/10 |
| Product Functionality | 8.7/10 | 7.8/10 | 7.1/10 |
| Would Buy Again | 100% | 94.9% | 82.4% |
| Keeps ALL Promises | 100% | 96.4% | 75.9% |
| Drives Tangible Outcomes | 8.4/10 | 8.1/10 | 7.4/10 |
“eInsights found coverage on accounts we had already written off as uncompensated care. In our first quarter alone, they helped us recover $2.8M in revenue with zero workflow disruption.”
— Revenue Cycle Director, 350-bed Hospital
How eInsights Solves What Others Miss
As of 10/13/2004, HIPAA requires health insurers to make available an Electronic Data Interchange (EDI) 270/271 transaction set designed for standardized eligibility inquiries. This gave providers a way to locate insurance missed at the point of service.
However, most companies only conduct insurance discovery on a provider’s self-pay population. eInsights takes a more comprehensive approach by:
- Scanning all patient accounts, not just self-pay
- Identifying where claims were sent to the incorrect primary payer
- Finding secondary coverage missed at point-of-service
- Continuously monitoring accounts as statuses change
Real Results: Midwest Hospital Case Study
In July 2023, a large safety-net hospital in the Midwest began using eInsights’ insurance discovery solution to address the following:
- Suspected unidentified insurance on self-pay accounts
- Numerous COB denials from Medicaid
- Staff constraints limiting their ability to investigate accounts
Comprehensive Coverage Identification
After engaging eInsights, the hospital received reports identifying:
- Medicaid, Commercial, and Medicare coverage on Self-Pay accounts
- Commercial coverage on accounts with Medicaid listed as the primary
- Medicare coverage on accounts with Medicaid listed as primary
- Medicaid Secondary on accounts with Commercial or Medicare as the primary
- Medicare Supplemental coverage
- Commercial coverage on accounts with different Commercial payers
- Medicare Secondary coverage on Commercial primary accounts
- Commercial primary, where only Medicare was loaded
Measurable Financial Impact
After just three months:
- Unknown coverage identified on 10.69% of self-pay accounts
- Unknown coverage was found on 3.24% of all patient visits across all financial classes
- $2.77 Million in additional reimbursement collected:
- $2.52 Million from accounts incorrectly registered as Self-Pay
- $253,000 from accounts with the incorrect primary payer or missed secondary coverage
Proactive Denial Prevention
Given the large number of COB denials from Medicaid, addressing the problem required ensuring the client could load appropriate insurance information before accounts reached final-billed status. The eInsights solution located 64% of the unknown coverage within 4 days of account referral, enabling correct initial billing and decreasing denial rates.
Superior Coverage Detection Capabilities
While many insurance discovery solutions limit inquiries by provider location, eInsights casts a broader net, locating:
- Coverage from 30 different state Medicaid payers
- A total of 117 unique payers across the country
- 20.5% found insurance with demographic information that didn't match 100% to the provider's records
End-to-End Solution
When the provider indicated they lacked the staff to load identified coverage, eInsights’ team loaded over 10,000 unique coverage records over three months.
This comprehensive approach delivered not only more billable coverage than other market solutions but also handled the coverage loading process, providing a complete end-to-end discovery solution unmatched in the industry.
The eInsights Advantage in Healthcare Revenue Cycle Management Services
Our healthcare revenue cycle management services stand apart from traditional approaches through:
Predictive, Not Reactive:
We identify insurance coverage opportunities before they become lost revenue, often identifying coverage before a bill drops.
Fully Managed Coverage Load Service:
Our team of revenue cycle experts handles the entire process, requiring no additional work from your staff.
Risk-Free Engagement:
We offer performance-based pricing models, ensuring you only pay for actual revenue recovered.
Compliance Focus:
All processes fully comply with federal and state regulations, including HIPAA, HITRUST, and patient privacy laws.
Continuous Improvement:
Our data scientists continuously refine our algorithms based on results, ensuring ever-improving performance.
Ready to Stop Leaving Money on the Table?
Discover how our unmatched insurance discovery services can transform your hospital’s financial performance without disrupting your operations.
Let us show you how we’ve helped similar organizations recover millions in otherwise lost revenue through our innovative insurance discovery technology.
Frequently Asked Questions
About Healthcare Revenue
Cycle Management Services
How does Coverage Discovery differ from eligibility verification?
A: Traditional eligibility verification is designed to verify already-known policy IDs and the specific benefits and coverages a patient has. Coverage Discovery operates on the unknown, searching for billable coverage the hospital and its vendors are unaware of.
What's the difference between the eInsights solution and other coverage discovery solutions?
A: Most other solutions only search self-pay accounts for unknown insurance, leverage dated technology, or search cached eligibility and claims databases instead of the payers directly. Because of this, eInsights finds close to two times what most other solutions find.
How quickly can we implement your solution?
A: Most hospitals are fully implemented within 30-45 days, with minimal IT resource requirements.
What types of insurance can you discover?
A:Our system identifies commercial insurance, Medicare, Medicaid, Medicare Advantage, TRICARE, and other government programs that patients may qualify for retroactively.
How do you ensure HIPAA compliance?
A: All our healthcare solutions are built with HIPAA compliance as a foundational element. We require a Business Associate Agreement to be in place before any transfer of PHI. Because of our security, we have become HITRUST certified.
What ROI can we expect from your services?
A:While results vary by hospital, our clients typically see a return of 6:1 to 10:1 after implementing our customized healthcare solutions, which are designed to fit their revenue cycle structure, payer mix, and internal workflows.
eInsights provides insurance discovery services for hospitals and physician groups nationwide. Our flexibility and focus on delivering value are why our clients like working with eInsights.