CoverMe

What CoverMe does

CoverMe Services, Inc. is a Birmingham, Alabama-based private healthcare technology company that operates a SaaS-enabled Healthcare Finance Marketplace for hospitals, health systems, skilled nursing facilities, assisted living facilities, and outpatient clinics. The platform performs real-time patient eligibility verification and coverage discovery across Medicaid, Medicare, commercial insurance, pharmaceutical assistance, charity care, and patient financing programs, using AI-driven rules and risk engines to score patient data and recommend optimal payer matches. Core products include CoverMe Marketplace, CoverMe Retrocheck (retrospective coverage recovery 90 days to one year post-discharge), CoverMe LTC, CoverMe Complete, and CoverMe Mobile Verify (smartphone-based identity capture).

The underlying technology is a cloud-based SaaS platform integrated via the Jitterbit API platform to state Medicaid systems, major commercial insurers, financing partners, EHRs, and pharmaceutical and community assistance programs. CoverMe also applies NLP to validate patient demographic and insurance data and uses image-based capture for touchless intake. The platform provides compliance tooling for IRS 501r, ACA, and Hospital Presumptive Eligibility (HPE) workflows.

CoverMe generates revenue through a combination of SaaS subscriptions, per-transaction coverage discovery fees, and contingency-based pricing on Retrocheck recoveries, with patient balance financing facilitated through lending partners. Go-to-market is primarily enterprise direct sales targeting hospital CFOs, revenue cycle directors, and financial counseling teams, supplemented by inside sales for mid-market providers and technology partner channels such as the Jitterbit integration. The company is co-founded and led by Catherine Engelbrecht as Chief Experience Officer, with no disclosed institutional investors or parent company.

Name

CoverMe

Legal name

CoverMe Services, Inc.

Website

https://cover.me

Company type

Private

Founded year

2018

Operating status

Operating

Headcount range

11–50 employees

Short description

CoverMe is a Birmingham-based healthcare technology company that provides a SaaS-enabled marketplace for real-time patient eligibility verification, coverage discovery, and front-end revenue cycle management, serving hospitals, skilled nursing facilities, assisted living facilities, and outpatient clinics across the United States.

Ownership category

akta.pro rank

Product category

Healthcare Revenue Cycle Management Software

NAICS

Computer Systems Design and Related Services (54151), Computing Infrastructure Providers, Data Processing, Web Hosting, and Related Services (5182)

SIC

Services-Computer Programming, Data Processing, Etc. (7370), Services-Prepackaged Software (7372)

akta.pro primary industry

Eligibility & Benefits Verification (HLACACAD)

Keywords

• Healthcare eligibility verification
• Patient coverage discovery
• Front-end revenue cycle
• Medicaid enrollment automation
• Patient balance financing

Headquarters

HQ city

Birmingham

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Software

Cost components

Technology or R&D, Personnel, Marketing or Sales, Infrastructure, Operations

Revenue model

1. SaaS Platform / Software Subscription: CoverMe operates as a SaaS-enabled marketplace, providing healthcare providers with subscription-based access to its coverage discovery and eligibility verification platform. The platform is described as offering provider-approved, patient-friendly selections of coverage and financing alternatives, with hospitals customizing their marketplace based on their programs of choice.
2. Transaction / Contingency-Based Coverage Discovery: CoverMe's Retrocheck solution identifies billable Medicaid, Medicare, and commercial insurance previously unknown, with hospitals benefiting from reimbursements recovered retroactively. The company also processes per-transaction fees for insurance discovery checks at scheduling, pre-registration, registration, and post-discharge stages.
3. Patient Balance Financing Programs: CoverMe connects patients with flexible financing options including interest-free, low-interest, and line-of-credit programs. The company earns revenue by facilitating patient financing arrangements that help hospitals increase net collections while decreasing bad debt write-offs.

Pricing tiers

Go-to-market motion2 records

Distribution channels3 records

Marketing channels6 records

Core offering

CoverMe operates a cloud-based, SaaS-enabled Healthcare Finance Marketplace that helps hospitals, health systems, skilled nursing facilities, assisted living facilities, and medical clinics verify patient insurance eligibility, discover billable coverage (Medicaid, Medicare, commercial, pharmaceutical, and charity programs), match patients with financing options, and automate Hospital Presumptive Eligibility (HPE) compliance in real time at the point of service. The platform combines an AI-driven rules and risk engine, NLP-based data validation, and image-based identity capture, integrated with EHRs and payer sources via the Jitterbit API platform.

Product overview

CoverMe is a SaaS-enabled marketplace that provides healthcare coverage optimization through a platform-plus-modules architecture. The core CoverMe Marketplace serves as the central hub for real-time eligibility verification and coverage discovery, supported by specialized modules including CoverMe Retrocheck (retrospective coverage discovery), CoverMe LTC (long-term care), CoverMe Mobile Verify (mobile identity verification), and CoverMe Complete (comprehensive package). The platform integrates coverage discovery, patient balance financing, financial assistance/charity screening, and HPE eligibility & compliance into a unified workflow, enabling providers to identify payer sources and optimize revenue cycle management from point-of-service through retrospective reviews.

Differentiator

Problem solved

Functional benefit

Products and services

• CoverMe Marketplace The core SaaS-enabled healthcare finance marketplace that provides real-time patient eligibility verifications and coverage discoveries, assesses eligibility at point-of-service, and recommends optimal financial support programs for patients. Built for hospitals, health systems, skilled nursing facilities, assisted living facilities, and medical clinics.
• CoverMe Retrocheck Retrospective coverage discovery solution that identifies billable Medicaid, Medicare, and commercial insurance previously unknown, hidden, or forgotten for self-pay patients, recovering reimbursements from 90 days to 1 year post-discharge. Used by hospitals and health systems to convert bad debt into collectable revenue.
• CoverMe LTC (Long Term Care) Specialized solution for skilled nursing and long-term care facilities covering Medicaid LTC eligibility determination, compliance, pre-admission financial assessment, and bad debt reduction for resident populations.
• CoverMe Complete Comprehensive bundled solution combining multiple CoverMe modules (Marketplace, Retrocheck, LTC, financing, financial assistance) for full-spectrum healthcare coverage optimization across the patient journey.
• CoverMe Mobile Verify Mobile-based identity verification solution that enables touchless eligibility determinations using smartphone-based capture of patient identification, insurance cards, and selfie authentication to autofill eligibility forms.
• Coverage Discovery Insurance discovery solution that uses patient information to identify all possible coverage options within seconds, surfacing government and commercial payer sources including hard-to-find third-party payers for hospitals and clinics.
• Patient Balance Financing Data-driven solution that pre-approves patients for flexible recourse and non-recourse lending programs, matching them with financing options based on propensity to pay to help hospitals improve net collections and reduce bad debt.
• Financial Assistance & Charity Custom workflow solution that screens uninsured or underinsured patients for, applies to, and tracks financial assistance and charity care options available to them.
• HPE Eligibility & Compliance Automated Hospital Presumptive Eligibility process that ensures ongoing HPE compliance and immediately assesses temporary Medicaid qualification at point-of-service, with identity, residency, citizenship, income, and asset verification and form autofill.

Quantifiable outcome

• 47% reduction in bad debt within the first calendar year for Caring Long Term Care Group
• +8 more outcomes

Named customers5 records

Segments4 records

Ideal customer profiles3 records

Technology focussed Yes

API detail

Has API

Yes

API docs

API detail

Core technology

AI maturity

App detail

Integration2 records

AI capability6 records

Feature8 records

Partnerships

One partnership is on record.

• JitterbitcoreTechnology or Integration · 19 November 2019CoverMe selected Jitterbit as its API integration platform to underpin the CoverMe Healthcare Finance Marketplace. Jitterbit's API integration platform enables CoverMe to connect data from state programs, major insurers, financing partners, community programs, pharmaceutical programs, EHRs, and other sources in real-time. This integration allows CoverMe to scale the number of coverage and financing programs in its marketplace, quickly bringing new offerings to market and supporting unlimited endpoints and workflows.

Scale indicators12 records

Recent moves6 records

Expansion highlights6 records

Market position

Competitive moat5 records

Key risks6 records

Key highlights7 records

Customer concentration

• Xx.com/4CoverMe
• LinkedInlinkedin.com/company/coverdotme

Revenue estimate

Valuation estimate

Number of profiles

Profiles1 record

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about CoverMe