Eligibility & Benefits Verification

[Karna - Kevin]

This is in response to Angela's post under the topic 'Introduction'.
Due to the significance of the issue in question, I'm posting it as a
separate discussion.

The Council for Affordable Quality Healthcare (CAQH) calls the ability
to verify patient insurance information "one of the biggest
administrative challenges identified by providers."

Angela, you've done the right thing by bringing up this topic here and
I'm sure that by doing so, you're also helping others to obtain
information and resources related to this topic.

Web-DENIS is only for the BCBS MI plans including Medicaid, but
Passport OneSource covers a huge list of payers across US. As you've
not mentioned the state or region your hospital is located in, I'm
giving some general references below to try out.

For multiple payers nationwide:

Emdeon - http://www.emdeon.com/ProviderSolutions/pos/index.php
MedAvant - http://www.medavanthealth.com/mymedavant.aspx
MedCurrent (for over 340 payers) - https://www.medcurrent.com/Home/Solutions.aspx
MEVSNET.COM - https://www.mevsnet.com/info.jsp
Healthia Exchange - http://www.healthiaconsulting.com/why_use_exchange.html


For all Medicare Intermediaries & Carriers:

IVANS - http://www.ivans.com/healthcare/providers


Apart from the above mentioned, there are a lot more free and paid
services found in the internet which help in online and real-time
verification of eligibility, benefits & claims status. I request
others too to inform about similar services they use and also to add
their inputs to this discussion.

Hope, this helps to some extent...

Thanks,
Karna


On Dec 27, 1:31 am, akeehn <anrke...@yahoo.com> wrote:
> Hello!
> I'm hoping I am posting this right!
> I'm a Collection Specialist for a small, rural hospital. I do a lot
> of pre-registration as well for outpatient surgeries, MRI's and other
> radiology test procedures. My question is on benefits verification.
> We use WebDenis and PassportOneSource to verify benefits/copays for
> these procedures, but I have found them to be quite inaccurate. Does
> anyone have any other good sites to use? Is there any way to get a
> more accurate estimate without calling the insurance company every
> single time?
> Thanks~
> Angela
>

[Gaurav Mundra]

Try Availity (www.availity.com). They claim to have over 1,200 health
plans on their list.

Regards,
Gaurav Mundra
Director, Truworth
HRCM Specialists

On Dec 27 2008, 9:19 am, Karna - Kevin <karna.ke...@gmail.com> wrote:
> This is in response to Angela's post under the topic 'Introduction'.
> Due to the significance of the issue in question, I'm posting it as a
> separate discussion.
>
> The Council for Affordable Quality Healthcare (CAQH) calls the ability
> to verify patient insurance information "one of the biggest
> administrative challenges identified by providers."
>
> Angela, you've done the right thing by bringing up this topic here and
> I'm sure that by doing so, you're also helping others to obtain
> information and resources related to this topic.
>
> Web-DENIS is only for the BCBS MI plans including Medicaid, but
> Passport OneSource covers a huge list of payers across US. As you've
> not mentioned the state or region your hospital is located in, I'm
> giving some general references below to try out.
>
> For multiple payers nationwide:
>
> Emdeon -http://www.emdeon.com/ProviderSolutions/pos/index.php

> MedAvant -http://www.medavanthealth.com/mymedavant.aspx

> MedCurrent (for over 340 payers) -https://www.medcurrent.com/Home/Solutions.aspx
> MEVSNET.COM -https://www.mevsnet.com/info.jsp

> Healthia Exchange -http://www.healthiaconsulting.com/why_use_exchange.html

>
> For all Medicare Intermediaries & Carriers:
>

> IVANS -http://www.ivans.com/healthcare/providers

>
> Apart from the above mentioned, there are a lot more free and paid
> services found in the internet which help in online and real-time
> verification of eligibility, benefits & claims status. I request
> others too to inform about similar services they use and also to add
> their inputs to this discussion.
>
> Hope, this helps to some extent...
>
> Thanks,
> Karna
>
> On Dec 27, 1:31 am, akeehn <anrke...@yahoo.com> wrote:
>
>
>
> > Hello!
> > I'm hoping I am posting this right!
> > I'm a Collection Specialist for a small, rural hospital.  I do a lot
> > of pre-registration as well for outpatient surgeries, MRI's and other
> > radiology test procedures.  My question is on benefits verification.
> > We use WebDenis and PassportOneSource to verify benefits/copays for
> > these procedures, but I have found them to be quite inaccurate.  Does
> > anyone have any other good sites to use?  Is there any way to get a
> > more accurate estimate without calling the insurance company every
> > single time?
> > Thanks~

> > Angela- Hide quoted text -
>
> - Show quoted text -