Insurance discovery.
OHI Discovery runs your accounts against an insurance repository that tracks additions, changes, and deletions from health plans, PBMs, dental benefit managers, exchanges, and workers' compensation carriers.
What we do
We find the coverage registration missed and bill the right payer the first time.
Patients change plans, forget to mention secondary coverage, or experience Medicaid eligibility changes, sometimes without even realizing it. When coverage isn’t captured at registration, claims go to the wrong payer or directly to the patient. OHI Discovery, our proprietary insurance discovery platform, finds that coverage so claims get paid and your revenue is protected.
OHI Discovery runs your accounts against an insurance repository that tracks additions, changes, and deletions from health plans, PBMs, dental benefit managers, exchanges, and workers' compensation carriers.
Standard 270/271 eligibility transactions confirm coverage in real time. When a payer's response is incomplete, our validation team confirms it directly with the payer.
Our teams review every policy, and a QA specialist checks it before it reaches your file. You get coverage data you can bill with confidence.
Verified coverage goes straight to your team or into a billing system. When we find coverage after the fact, we can back-bill every eligible date of service.
280M+
lives covered
1,000+
commercial plans
Weekly
payer updates
We search health plans, PBMs, dental benefit managers, exchanges, and workers’ compensation carriers, covering more than 280 million lives and 1,000-plus commercial plans. Direct data agreements with payers give us real-time policy access to 99% of insured lives.
Self-pay and bad-debt accounts typically offer the biggest return. These balances fall to the patient, and many go unpaid. Some patients may have active Medicaid, Medicare, or commercial coverage that wasn’t captured at registration. Finding it early, before an account goes to collections, lets you bill the right payer for revenue that would otherwise be written off. Discovery also pays off on denied claims and for patients who may carry secondary coverage.
A patient may be covered as a dependent on a spouse’s or parent’s plan, still have COBRA or retiree benefits, or have become eligible for Medicare without realizing it. After an accident, auto, liability, or workers’ compensation coverage may be responsible. Medicaid beneficiaries often assume Medicaid covers everything and don’t mention other plans.
Tell us what you’re working on, and the right person on our team will follow up.