Coverage Discovery
Identifying billable coverage on self-pay and unresolved balances before write-off.
What it covers
- Self-pay balance screening for active coverage
- Retroactive Medicaid identification
- Secondary and tertiary coverage discovery
- Motor-vehicle and workers' compensation identification
- Coverage verification and claim rebilling
- Pre-write-off screening
Where practices lose money here
Self-pay balances that were never self-pay
A meaningful share of self-pay balances have findable coverage — retroactive Medicaid, an unreported secondary, an accident claim.
Secondary coverage never billed
Primary pays, the balance moves to patient responsibility, and an existing secondary policy is never touched.
Write-offs before screening
Once a balance is written off, nobody goes looking. Screening has to happen before the write-off, not after.
How Medway handles it
- Every self-pay balance is screened for active coverage before it is proposed for write-off.
- Retroactive Medicaid and unreported secondaries are identified and the claim is rebilled.
- Accident-related balances are checked against MVA and workers' comp coverage.
- Findings are documented so the coverage is on file for future encounters.
What you get
- Coverage found before the balance is written off
- Retroactive and secondary coverage billed
- Accident-related balances routed correctly
- Coverage data captured for next time
Get a free audit of your coverage discovery claims. Send us a recent aging report and we will show you, in writing, where the recoverable revenue is — no cost, no commitment.
Frequently Asked Questions
You send us a recent accounts receivable aging report and, where possible, a denial export. We review them and give you a written breakdown: where recoverable revenue is sitting, which denial reasons are costing you most, what your timely-filing exposure looks like, and the fixes we would make in priority order. It is yours to keep whether or not you work with us. Please do not include patient health information — we only need claim-level financial data.
Most of the timeline is payer enrollment and EDI setup, and neither is fully in our control — that is the honest answer. Practices already enrolled with their payers typically start seeing claims go out within two to three weeks. Where new enrollments or revalidations are needed, budget longer, because the payer sets that pace. We tell you which of the two you are in after looking at your current setup.
Solo practitioners are often the strongest case for it, not the weakest. A one-person billing office has no redundancy — a vacation or a resignation stops your revenue cycle, and the cost is not the temp, it is the AR that ages and the claims that pass their filing deadline while nobody is working them.
Access to your existing EMR/PMS, your payer list and contracts, your fee schedule, and a recent AR aging report. If you are moving from another biller, we also need clarity on who works the open AR at transition — that is the single most commonly mishandled part of a billing switch.
