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Eligibility is one of those misleading sources of denials. You may think you’re covered because you’ve had an eligibility vendor for years. But that’s often not the case. Eligibility remains one of the largest sources of denials that originate in patient access. With patients moving in and out of exchange plans, and the pervasiveness of Medicare and Medicaid advantage plans, eligibility is no longer just a ‘Yes or No’ question. Your patient access staff needs an efficient way to get true levels of coverage before and after services to prevent denials.
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