CoverMe Information

Every day, hospitals deliver care to patients who were eligible for coverage and never get paid for it. Every day, state agencies make eligibility decisions on incomplete information with staff who are already stretched. CoverMe was built to fix both. For providers, CoverMe determines Medicaid eligibility in real time and screens every patient against every payer source — Medicaid, Hospital Presumptive Eligibility, commercial insurance, financial assistance, charity care, and patient financing — with applications pre-filled and completed in minutes at the point of service. A 47-bed critical access hospital cut bad debt 27% in its first year. A teaching hospital eliminated $16M in uncompensated care in 14 months. A 175-facility long-term care group cut Medicaid-denial bad debt 47%. Average return: 20X. For states, CaseVue brings the same verification and risk-scoring engine to Medicaid, SNAP, and human services agencies. Each case receives a risk score, the factors behind it, and the sources that support it — so eligibility and program-integrity staff review the files that need it, clear the ones that don't, and keep every determination defensible. CaseVue works alongside existing eligibility systems; decisions stay with the agency.