Eligibility Verification

Get patient visits off to a smooth start

Optum™ Intelligent EDI Eligibility is a web-based tool that enables hospitals to quickly and accurately determine eligibility within seconds from participating payers, including details about the patient’s primary care provider, copay and deductible.

Efficiency in real time

Run real-time reports directly from the user interface. Choose either real-time or batch verifications on eligibility checks. This clarity from Intelligent EDI Eligibility helps you reduce your financial risk by knowing the current general benefit information such as deductible and co-pay amount prior to services as well as details of coverage including plan type.

Key benefits:

Determine patient eligibility quickly - Check eligibility in seconds, not minutes, with direct access to up-to-date payer eligibility data.

Get important 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 that will apply and have a better sense of their coverage.

Increase productivity - With Intelligent EDI Eligibility, eligibility information arrives within seconds, enabling front-office professionals to spend more time interacting with patients and take care of other important work. This access and speed significantly reduces phone time and administrative logjams.

We’re ready to put our platform to work for you. Let’s start the conversation.
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For information about an Optum360 solution for your business please complete the form below. To speak with us sooner call 1-866-223-4730 or email Optum360@optum.com.

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