RCover™ Last-in-Line Medicare & Medicaid Eligibility Recovery Program can turn a surprisingly substantial portion of a hospital’s bad debt, charity, and written-off accounts into payments from Medicaid, Medicare, and other third-party payers.
Key elements of RCover™ include:
Proprietary Technology/Process Includes Manual Match
- In addition to using proprietary technology, RCover™ performs a manual match process that computers alone cannot duplicate. RCover’s combined computer and manual data-mining creates comprehensive patient profiles, including demographic and historical service information. This maximizes recovery opportunities. Many competitors solely rely on a computer match algorithm.
Ability to Create Retroactive Coverage – Often with Very Old Claims
- RCover™ continuously monitors for changes in eligibility, regardless of age of service. Many disability applications are denied and then overturned two or more years after the hospital visit. RCover™ works with CMS, SSA, and Social Services to obtain proof of retroactive eligibility and then submits manual claims to override timely-filing denials. Many competitors only work claims within 12 months from date of latest service.
Substantial Medicare Recoveries
- RCover™ successfully identifies retroactive fee-for-service Medicare eligibility cases resulting in hospitals receiving substantial reimbursement, often for services greater than two years old. Many competitors focus primarily on Medicaid.
- RCover™ provides advocacy services for patients who have had their applications denied. This positively impacts patient satisfaction. Many competitors do not contact patients to help them obtain coverage.
Attorney and Clinical Resources to Overturn Denials
- RCover™ uses the power of attorneys and clinical professionals to overturn any denials received after eligibility is successfully discovered. No competitors combine this resource with their eligibility solution.
- RCover™ can do the billing, both electronically and via paper — without charging extra. RCover™ billers are both CPAR and CPAT certified. Many competitors charge extra for billing or don’t offer billing at all.