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Eligibility

Prevent eligibility related rejections and denials with eSolutions Eligibility. Whether you need to check eligibility and coverage on your Medicare, Medicaid or commercial payer patient, we return the most comprehensive, real-time patient data in seconds.

Medicare Eligibility

Thanks to our real-time unique connection to Medicare, you’ll have comprehensive patient data in seconds:

Personal Information

  • Name
  • Birth date
  • Medicare Beneficiary Identifiers (MBI) number validation
  • Gender

Coverage Information

  • Type of coverage (Part A or B)
  • Medicare HMO and/or Advantage Plans
  • Deductible data
  • Days information
  • Preventative services
  • Medicare Secondary Payer (MSP) insurance
  • Home health sessions
  • Hospice periods

Multi-Payer Eligibility

With innovative technology and direct connections to thousands of Medicaid and commercial insurers, you’ll get eligibility data returned in seconds:

  • Beneficiary and subscriber verification
  • Eligibility and benefits
  • Coverage type
  • Co-Pay and deductible data
  • Provider/service specific coverage data
  • Other important information like primary care physician, plan effective dates, and prior authorization requirements

Advanced Eligibility Features

Cascading Eligibility Search

Finds all your patients’ coverage by searching multiple payers at once, including Medicare, Medicaid and Commercial payers.

Medicare Advanced Eligibility Search

Automates verification for Medicare Advantage, Medicare Secondary Payer, Medicare Part D and/or QMB plans.

eSolutions’ Eligibility is the solution for providers who want to

  • Reduce eligibility related denials and rejections

  • Increase point-of-service collections by having the most current co-pay and deductible information

  • Efficiently verify eligibility from one single, powerful interface users can customize

  • Need batch features to check multiple patients at once at multiple points in the reimbursement cycle

Request more information on our eligibility solution

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