- Overview
- Features & Benefits
- Sample Screens
ClaimRemedi Electronic Eligibility
Verifying patient eligibility is always the first step in successfully managing the claim Lifecycle process. If you check eligibility by phone, you will only verify patient coverage for as many patients as staff time allows. The number one reason for rejected claims is invalid or incomplete subscriber information.
ClaimRemedi solves this problem by delivering critical eligibility data to your desktop in a matter of seconds using a standard web browser -- allowing you to obtain and verify the correct subscriber information before claims are submitted. Eligibility responses can also show what you need to collect from your patients to cover co-payments and deductibles.
Eligibility responses are presented in a consistent, easy-to-read format. All information is organized so that your staff can quickly find what (for example, co-payment amount) you are looking for—without having to wade through several pages of randomly arranged response information. All information is displayed in a consistent format regardless of the payer.
Eliminates the need to log on and log off of multiple payer websites, each with their own unique logon and display of information formats.
Obtain real time eligibility information from payer websites without logging on to individual payer websites through our enhanced payer access solution. We access the different payer websites—but provide you with a single logon for all payers—and we “normalize” all information so that it is presented in the same, consistent and easy-to-read format.
Guides and prompts are displayed to ensure that different payer requirements are met when submitting eligibility requests. Does the payer require the patient’s date of birth, etc.? This includes error checking with automatic resubmission.
“Real-time” eligibility responses are returned within 3-7 seconds.
Eligibility requests can be submitted in a batch mode to facilitate the processing of information for many patients (for example, tomorrow’s schedule).
Your staff can individually set up and manage their own work lists with regards to their own preferences, inputting eligibility requests, saving responses on work lists and creating reports. Supervisors can be provided with access to all work lists and reports.
Payer responses can be immediately displayed for review or automatically moved to a work list for later review.
Features & Benefits
Fast Access to Eligibility in Seconds
- Releases staff from being tied up with phone calls
- Eliminates the need to log on and off of multiple payer websites
- Quickly find the information returned by payers that you need without wading through several pages of randomly arranged response information.
- Upload day or week ahead Schedules directly from your Practice Management or HIS system
Easy to learn and use
- Guides and prompts are displayed to ensure that different payer requirements are met when submitting eligibility requests
- Staff can individually set up and manage their own work lists with their own preferences
- Payer responses can be immediately displayed for review or automatically moved to a work list
- Customizable payer lists
A Complete Eligibility Solution
- Batch or Real Time
- Enhanced feature that allows obtaining Real Time Eligibility directly from payers website
- Error checking with automatic resubmission
- Variety of interfacing and file format options including X.12 and XML via Web Services
Product Examples
Click on the Images below to see examples of the ClaimRemedi Eligibility Portal's User Interface
