Eligibility Verification

Connect to an extensive group of payers to verify patient eligibility and benefits. Verify coverage, identify provider database discrepancies and determine patient financial responsibility, while the patient is onsite.

Intelligent EDI offers real-time and batch eligibility verification. Submit eligibility requests via API integration, file upload or direct data entry, and receive information directly from payers.

Additional eligibility capabilities:

  • Benefit-level sorting: Prioritize benefit-level responses by service type, to quickly view coverage information.
  • Benefit summary table: Use EDI dashboard summaries to easily determine patients’ out-of-pocket costs.
Key benefits:

Determine patient eligibility quickly - Check eligibility in seconds, with direct access to up-to-date payer eligibility data.

Obtain copay and deductible information - By connecting directly with payer data, hospitals can manage copays, deductibles, and other information up front.

Identify primary care provider - Administrators automatically receive detailed information on the primary care provider.

Keep patients informed - Patients are notified of potential charges and have a better sense of their coverage.

Increase productivity - Information arrives within seconds, enabling front-office professionals to spend more time interacting with patients.  

We’re ready to put our platform to work for you. Let’s start the conversation.
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