We are the eligibility experts. Patient ineligibility is the number one reason claims are rejected. eSolutions’ eligibility tools find the real-time coverage you need, when you need it. With a direct connection to Medicare, and access to more than 5,500 commercial payers, our exclusive technology returns more patient coverage information. This means you get complete benefit and co-pay details within seconds, reducing rejections and denials while improving cash flow.
With solutions for Medicare, Medicaid and commercial claims, eSolutions automates claims submission and management. By leveraging connections with Medicare and thousands of commercial payers, we ensure providers submit the cleanest claims possible. eSolutions also tracks and monitors claims as they travel through the revenue cycle, providing actionable, real-time intelligence to enhance claim workflow, increase efficiencies and optimize healthcare payments.
Healthcare organizations need increased transparency into data to survive in today’s market. Not only do you need data, you must know how to use it. eSolutions’ analytics tools, benchmarking and comparative analytics products turn complex data into actionable insights. We leverage data from our systems and hundreds of thousands of providers to help organizations optimize reimbursement, care quality and operational performance.
Audits and Denials
Powerful denial insights and management capabilities give eSolutions’ clients the advantage. Not only do we help you expertly prevent denials, our products conveniently track and direct you to appeal them when they happen. We arm organizations with real-time remittance data so you can find denial prevention areas that need attention. Our appeals management platform streamlines and automates audit response and appeal workflow so organizations get the reimbursement they deserve quickly.
Quality and ComplianceeSolutions’ quality and compliance tools deliver the services and analytics providers need to identify opportunities to improve quality outcomes, boost Five-Star Ratings, reduce readmissions, increase referrals and drive cash flow.
- Spend less time uploading files
- Decrease rejections and denials
- Reduce manual work and analysis
- Stay on top of Five-Star Ratings
- Improve reimbursement, speed, accuracy and cash flow