Our solution

Discovery Health Partners has developed a unique approach to managing member eligibility independent of a claim being filed. Our solution enables health plans to proactively correct eligibility errors at the source and pay more claims correctly the first time, resulting in millions in cost avoidance and overpayment recovery.

Our solution analyzes internal and third-party data sources to identify potential eligibility errors, then applies rigorous validation processes to accurately determine eligibility status. We create a trusted source for verified eligibility data, which delivers improved payment accuracy and member and provider satisfaction.

  • Proactively correct member eligibility errors
  • Avoid downstream eligibility overpayment costs
  • Reduce claims re-processing costs

Our results

30%

increase in cost avoidance

Our technology

Discovery’s solutions are built on the Healthcare Analytics Platform, integrating powerful data, analytics, and business process capabilities.

HIPAA compliant

Advanced analytics

Industry-leading security

Insightful reporting

Cloud-based platform

Automated workflow

Learn more

Eligibility management solution overview

A comprehensive approach to identifying other coverage can help your plan maximize recoveries and drive cost avoidance.

On demand: Next-generation eligibility

Join Paul Vosters, president of Discovery Health Partners, as he discusses how eligibility data management fixes could add millions to your plan’s bottom line.

Why is eligibility data management so complex?

Watch our brief video to learn about five challenges that impact the accuracy of eligibility data, which is the root cause of many payment integrity challenges.

 

Rey VillarEligibility Management Resources