Electronic Insurance Verification

Electronic Insurance Verification helps to solve the problem of missing or invalid insurance information that can cost a practice time and money. By utilizing state of the art technology the application can automatically retrieve insurance and benefit information in just seconds. This process can also be manually triggered at any time. The results the inquiry are automatically stored – no typing required. This provides an imediately recognizable productivity booster, EMD makes checking insurance eligibility so fast, there’s no reason not to do it for every patient. This inoformation is posted in the application dashboard for all appropriate staff to see with a glance.
This feature can be support via connections to Insurance clearing houses such as Emdeon or Availity. If clearing house are not feasable connections to individual insurance carriers can be established.
Features Include:
  • Accurate determination of patient co-pay and deductible
  • Minimizes claim denials, reducing accounts receivable problems, and improving cash
  • Easy to use, no additional learning curve, improvement in productivity
  • Facilitates the patient enrollment process
  • Real-time processing with immediate response within the application
  • Saves administrative time and reduces labor costs
  • Meets all HIPAA/CMS criteria for identification, authentication, and encryption
  • Rules-based for client flexibility and customization
  • EDI (5010)
  • 270 Transaction Eligibility/Benefit Inquiry
  • 271 Transaction Eligibility or Benefit Information (response to 270)
  • 276 Transaction Claim Status Request
  • 277 Transaction Claim Status Notification (response to 276)
  • 837 Transaction Professional healthcare Claim
  • 835 Transaction Claim Payment/Advice (Electronic Remittance)
  • 277A Transaction Claim Acknowledgement (Replaces Submission Summary Report)
  • 999 Transaction Functional Group Acknowledgement
The insurance benefits information returned will be stored as part of the patient record and an automatic notice that the eligibility checking has been done will be made on the patient's appointment record.  Additionally, a print-out of the benefits information for the patient can be produced.
This feature is an intergrated into the EMD products and is also available as an SKD.