Automated eligibility verification software provides complete benefit details in seconds.
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.
Decrease eligibility-related denials
Using Recondo’s patented ReconBot® technology, EligibilityPlus™ automatically retrieves and combines data from payer portals and electronic eligibility (EDI 270/271) transactions to present the most complete benefit detail available. Accurate coverage is quickly identified from both commercial and government plans, including exchange plans. With EligibilityPlus™, there’s no need to pay a third-party to perform self-pay eligibility checks. Our automated solution verifies pre-and-post service if patients that identify as self-pay qualify for commercial or Medicaid coverage. EligibilityPlus™ seamlessly integrates with most major health information systems, including Epic, Cerner, McKesson, Meditech, Allscripts and Artiva.
EligibilityPlus verifies eligibility on commercial and government plans, and even supports Medicare DDE eligibility checking.
As an extra measure of protection, we provide intelligent and actionable alerting of denial risk with actionable guidance for your patient access staff.
EligibilityPlus easily works with most of the major health information systems, including Epic, Cerner, McKesson, Meditech, Allscripts and Artiva.