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Coverage Discovery

Undisclosed Coverage — Here's What You're Missing

Coverage DiscoveryFebruary 2022 · Refreshed 2026CoverMe Team

An estimated 20% of patients classified as "self-pay" actually have unidentified coverage. Every one of those accounts is revenue your facility earned and simply never billed.

Why coverage goes undisclosed

  • Patients don't know about secondary or tertiary insurance
  • Job changes leave patients genuinely confused about current coverage
  • Patients don't realize they qualify for retroactive Medicaid
  • High deductibles lead some patients to withhold insurance information
  • Payer changes never get communicated to the provider
  • Patients transition to Medicaid after receiving treatment

Every scenario leaves hundreds or thousands of dollars on the table — per account.

The safety net: retrospective discovery

CoverMe's Retrocheck works in three steps:

  1. Validate: real-time data assessment confirms self-pay status and demographic accuracy
  2. Screen: every account is checked for Medicaid and commercial payer coverage
  3. Recover: providers bill the found coverage; patients discover benefits they didn't know they had

Patients get covered. Hospitals get paid. Retrocheck has driven $70M+ in conversions on self-pay charges and uncovered $200M+ in hidden billing opportunities.

The window is closing

Under the 2025 Medicaid law, retroactive coverage windows shrink from 90 days to 60/30 days in 2027. The undisclosed coverage sitting in your bad debt today may literally not be billable next year — which makes proactive discovery time-sensitive in a way it has never been before.

Run your aged accounts before the retro window closes.

Send us a test batch — Retrocheck will show you exactly what's recoverable in your bad debt.

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