Web based Patient & Insurance Eligibility.  Before you bill you need to check patient coverage.   Click above line for more info...

Most plans have realtime eligibility.  When you check patient and plan eligibility and coverage you know your payment is more secure.

  Verifying insurance coverage is necessary to prevent write-offs caused by uncovered patient
services. However, the traditional verification process is time-consuming and cumbersome.
Our Eligibility Verification is a Web-based verification solution that provides quick, online confirmation
of patient insurance and benefit coverage retrieved directly from a payor’s database.
Verifying eligibility for healthcare services reduces the likelihood of bad-debt write-offs.
Eligibility Verification is an integrated part of SimpleClaims offering. SimpleClaims
offers a next-generation Web portal and suite of integrated solutions that enables collaboration
among providers, payors and patients throughout all stages of the revenue cycle.

 Through the user-friendly Web portal, Eligibility Verification enables a healthcare
organization’s scheduling, admitting and  patient accounting staff to obtain insurance
information when and where they need it —anywhere in the health enterprise. In
addition to verifying benefits, an inquiry response can include patient demographics,
member and subscriber ID, coverage status and co-payment amounts.
For Real-time Processing: The exchange of insurance information takes place securely,
in real-time via the RelayHealth network. Eligibility Verification can be configured to
the user’s preferences, and its easy-to-use worklist features keep the verification
process running smoothly.

Benefits Eligibility Verification offers you the following advantages:
• Provides an easy-to-use solution for verifying insurance eligibility at any point
throughout the enterprise
• Reduces denied claims and bad debt byretrieving up-to-date eligibility status,
including co-pay and deductible amounts,directly from the payor’s database
The RelayHealth Eligibility Verification Process Instantly
Identifies the Patient’s Covered Benefits as Well as Provides an
Inquiry Response Which Can Include Patient Demographics,
Member and Subscriber ID, Coverage Status and
Co-payment Amounts.

Real-time and Batch Processing• Improves cash flow by allowing immedi-
ate collection of patient payment for any treatment that is identified as not covered
by insurance • Increases total revenue by identifying eli-
gible recipients who previously would be incorrectly classified as self-pay
• Decreases accounts receivable (A/R) days by reducing claim rejections
• Identifies Medicaid-eligible recipients who previously were classified as self-pay,
reducing the potential that the payment will never be collected
• Saves administrative time by eliminating phone calls, fax transmissions and other
forms of communication used to determine if a patient is covered by insurance
and eligible for treatment
• Simplifies training through the use of a single solution that can replace various
telephone, point-of-service devices and payor Web site procedures
• Enables regulatory compliance using ANSI 270/271 version 4010 transactions in accor-
dance with the Implementation Guidelines under the Health Insurance Portability and
Accountability Act of 1996 (HIPAA)
• Increases patient satisfaction by reducing patient and payor conflicts
• Provides secure access by authorized users via user password
• Supports multi-user capability

For more information about Eligibility
Verification or SimpleClaims transaction
services, please call 800.441.5473 or
visit us at www.simpleclaims.com or www.dmefree.com
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