- Revenue Cycle Protection
Stop Losing Marketplace Revenue to Premium Delinquency
Hospitals lose millions every year due to ACA Marketplace premium delinquency and retroactive coverage termination. RevOne’s Delinquent Premium Monitoring identifies at-risk patients before claims are denied or payments are recouped, and contacts patients to help resolve payment delinquency.
20+
Years Healthcare Revenue Cycle Expertise
Millions
In Marketplace Revenue Protected
Deep
Experience with Complex Hospital Billing
The Hidden Financial Risk of ACA Marketplace Coverage
ACA Marketplace plans allow a 90-day premium grace period. During months two and three, hospitals face significant financial exposure that most revenue cycle teams don’t see coming.
Month 1
Coverage Active
Claims process normally. Insurer pays during initial grace period month.
Month 2
Claims Pending Risk
Month 3
Retroactive Termination Risk
- Risk Intensifies by Month
Hospitals can lose hundreds of thousands to millions annually from avoidable Marketplace delinquency write-offs.
Delinquent Premium Monitoring
RevOne’s Delinquent Premium Monitoring identifies Marketplace patients in premium delinquency before claims are denied or payments are recouped.
Grace Period Identification
Identify patients in the ACA premium grace period before claims are impacted.
Proactive Monitoring
Continuous monitoring of Marketplace accounts for delinquency signals.
Patient Outreach
Resolve delinquent premium issues before coverage termination occurs.
Revenue Protection
Reduce recoupments and stabilize reimbursement across your Marketplace population.
How RevOne Protects Marketplace Revenue
A proven three-step process that identifies and resolves Marketplace premium risk before it impacts your bottom line.
01
Identify At-Risk Accounts
Marketplace patients in premium delinquency are flagged early through automated monitoring.
02
Resolve Coverage Risk
03
Protect Reimbursement
Example: Preventable Marketplace Revenue Loss
Oncology Inpatient Case
Real-world scenario illustrating Marketplace revenue risk
Patient admitted for oncology treatment
Total claim value: $84,000
Coverage appears active but patient is in grace period
Premium never paid. Coverage terminates retroactively.
Hospital faces $84,000 recoupment
RevOne monitoring identifies the risk early
Hospitals can act before revenue is lost.
What Revenue Cycle Leaders Say
“Delinquent Premium Monitoring significantly reduced our Marketplace recoupments and protected high-dollar inpatient claims.”
VP Revenue Cycle
Regional Health System
“The proactive monitoring prevented thousands in avoidable denials. It’s now a key part of our Marketplace strategy.”
Director of Patient Financial Services
Frequently Asked Questions
No. Delinquent Premium Monitoring complements your existing eligibility verification process. It adds a focused layer of monitoring specifically for ACA Marketplace premium delinquency that standard eligibility checks don't capture.
RevOne monitors patients identified with ACA Marketplace coverage. We track premium payment status and grace period progression to flag accounts at risk of retroactive coverage termination.
Most implementations are completed within 2–4 weeks. RevOne works closely with your revenue cycle team to integrate monitoring into your existing workflows with minimal disruption.
Yes. Delinquent Premium Monitoring is designed to integrate with your current revenue cycle management systems and workflows. We provide alerts and reporting that fit into your existing processes.
Stop Losing Marketplace Revenue to Premium Delinquency
