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Eligibility and eChecker

Multi-payer eligibility verification that works when you need it.

Verifying patient insurance eligibility is a critical step in the revenue cycle. Using our HIPAA-compliant eligibility verification solution lets you verify patient information and coverage quickly and easily. Our eligibility verification solution helps automate your efforts to stay on top of changes in coverage. You won’t spend valuable time on patients without coverage, non-covered services, unallowable services, expired coverage limits and data discrepancies. This effectively reduces denied claims and line items while improving cash collections.

Our eligibility verification tool identifies:

Coverage Information

  • Beneficiary and subscriber verification
  • Eligibility and benefits
  • Coverage type
  • Deductible data
  • Provider/service specific coverage information

eSolutions' eligibility tool puts even more information at your fingertips. By directly retrieving data from individual payer websites, our exclusive technology electronically delivers important information like a patient’s primary care physician, plan effective dates, prior authorization requirements and more. This means more accurate claims and less time manually searching for patient information in other locations.

eChecker

If your office experiences a lag in the accuracy of Medicaid eligibility confirmation, eChecker is a powerful solution. Don’t write off patient bills that may have been denied due to an inaccuracy in Medicaid’s system. eChecker’s fully automated process checks patient Medicaid eligibility information, including retroactively checking accounts on which you previously received a denial.

eChecker uses multiple identifiers to find patients you may not have known were enrolled in Medicaid. For self-pay patients, our tool offers a coverage discovery feature allowing you to find patient eligibility for government and commercial coverage that may be missing or unknown during registration. These safeguards boost the chances of securing payment for care that may otherwise go uncompensated.

As often as you'd like using eChecker, send us your patient data and we'll automatically generate a report confirming eligibility along with specific coverage details. eChecker can search past months' outstanding debts to see if your previous month’s ineligible patients have received retroactive enrollment.

For one eChecker client, the solution reviewed over 400,000 encounters in a single calendar year, resulting in $250,000 in recovered Medicaid revenue.

Let us help you improve the efficiency of your claim lifecycle from start to finish.