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Patient Eligibility and Benefit Verification


EligibilityPlus® gives hospitals the most complete view of patient insurance benefits available in the industry. With a complete understanding of insurance benefits, hospitals immediately identify specific coverage, simplify patient registration workflows, reduce claim rework, and assess patient liability.

HFMA Peer Review

Key to Payment

Accurate and timely patient eligibility data is crucial to a provider's revenue cycle management performance. Identifying patient eligibility and benefit plan details early in the revenue cycle allows for faster patient collections and more accurate claim submission, improving revenue collection and cash flow while reducing administrative expenses.

Eligibility Tools

While striving to provide service to patients, providers are confronted with a dizzying array of both payers and benefit plans. If a provider fails to accurately assess specific benefit eligibility, payment is often delayed or forfeited. EligibilityPlus gives providers the tools necessary to collect from payers and patients in a timely and efficient process.

Industry's Best Eligibility Details

EligibilityPlus is designed to give providers real-time eligibility verification and the most comprehensive benefit response available. You need to know more than if a patient is eligible under a particular insurance plan; you need to know the specific benefits for the services you provide. With integrated EDI and Payer web-portal benefits, EligibilityPlus gives you the specific benefits you need to accurately assess and complete eligibility and benefit verification.

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Case Study: Washington

* HFMA staff and volunteers determined that this product has met specific criteria developed under the HFMA Peer Review Process. HFMA does not endorse or guarantee the use of this product.