Healthcare Revenue Cycle

We’re the ones
that get your
patients insured

Since 2003, we’ve been partnering with revenue cycle teams to help convert
uninsured individuals into insured, seamlessly integrating into your existing
systems. Our solutions and dedicated support teams enhance your current
technology and workflows.

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INTEGRATED SOLUTION

The MyCareCoverage Ecosystem

Technology + Advocacy = Results

MyCareCoverage App

  • Instant eligibility screening for Medicaid and ACA/Marketplace.
  • Secure document upload
  • E-signatures
  • Real-time status and guided enrollment

Perfiniti Insurance

  • ACA/Marketplace enrollment
  • Medicare Plan enrollment
  • Plan comparisons and subsidy calculations
  • Education, renewals, and ongoing support

The WellFund

  • Medicaid and Medicare Savings Program enrollment
  • State-specific program navigation
  • Compassionate, patient-centered guidance

MyCareCoverage – The Technology Backbone

MCC streamlines enrollment by connecting patients to coverage faster.

• Multi-Plan Screening: Instant eligibility for Medicaid, ACA/Marketplace, and Medicare.
• Year-Round Support: Continuous screening for SEP and Qualifying Life Events.
• Real-Time Processing: Secure document upload, e-signatures, and instant coverage confirmation.
• Guided Workflow: Step-by-step patient journey with integrated Patient Advocate support.

How It Works

1. Access: Patients enter via a unique Personalized URL (PURL).
2. Screen: Intelligent self-screening for all insurance options.
3. Submit: Real-time document upload and e-signature.
4. Finalize: Expert Advocate assistance to complete enrollment.
My Care Coverage

Delinquent Premium Monitoring

Protect ACA Marketplace coverage during the 90-day grace period—reduce recoupment risk, prevent avoidable denials, and preserve reimbursement for high-cost cases.
Built for hospitals and health systems managing ACA Marketplace exposure.
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The Hidden Risk: The 90-Day Grace Period

ACA Marketplace plans may allow a 90-day premium grace period. During that window, coverage can appear active while premiums are delinquent—creating exposure for hospitals.

What Delinquent Premium Monitoring Prevents

Recoupments

Avoid repayment demands tied to retro terminations.

Unnecessary Denials

Resolve delinquency before claims age out.

Treatment Delays

Support continuity of care by stabilizing coverage.

Write-offs

Reduce preventable bad debt tied to coverage lapses.

Designed for High-Risk, High-Dollar Cases

DPM prioritizes accounts most likely to drive significant reimbursement loss if coverage lapses.

  • Marketplace primary payor (payor list varies by state).
  • Inpatient encounters where exposure escalates quickly.
  • Oncology and other high-cost episodes of care.

What Is Delinquent Premium Monitoring?

Delinquent Premium Monitoring (DPM) is a proactive program that identifies Marketplace members in premium delinquency and helps restore coverage before claims are lost.

Outcomes That Matter to Revenue Cycle Teams

DPM is designed to reduce preventable reimbursement loss and lighten the administrative burden caused by premium delinquency.
  • Reduce recoupment risk tied to retroactive terminations.
  • Increase the percentage of high-risk accounts that resolve before timely filing deadlines.
  • Improve cash flow by minimizing pended claims and repeated rework.
  • Provide patient-friendly resolution pathways that support continuity of care.

How It Works

Detect Delinquency

Daily monitoring + eligibility verification to identify Marketplace accounts in the grace period.

Outreach & Explain Options

Contact the patient with a structured script to confirm status and obtain approval to proceed.

Premium Support & Tracking

When applicable, facilitate catch-up premium payment and track progress to completion.

Confirm Coverage & Protect Claims

Re-verify active coverage, then proceed with clean claim submission/resubmission and follow-through.

Stop Losing Marketplace Revenue to Premium Delinquency

Let’s build a DPM workflow tailored to your payor mix, service lines, and operational structure.
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