Billing, Scheduling, Reporting seamlessly integrated with our state-of-the-art Clearinghouse and with MediTouch EHR®
- Eligibility & Benefits
- Claim Status
- Referral and Authorizations
Need Status on Many Patients? Ask us about bulk Real-Time!
Instant Eligibility, Benefit, and Claim Status Data
Tired of waiting on hold? Use HealthFusion® Real-Time data exchange to verify eligibility, benefits, and claim status. Real-Time access means eligibility verification, member benefits, and claim status (details on, if, and how a claim was paid) in just seconds.
Most practices learn the hard way that the health insurance membership card is not definitive proof of patient eligibility for healthcare benefits. In fact, the most common cause of rejection at the payer gateway is directly related to eligibility.
Not only is the typical membership card not proof that the patient is actually insured, but it does not contain the critical patient benefit information required to make important co-pay and referral decisions at the point of care.
Eligibility from HealthFusion® is feature-rich, and a simple way for your practice to accomplish electronic eligibility verification at the point of care.
- Reduced time required to verify eligibility and benefits
- Provides more comprehensive information than most swipe-card terminals and interactive voice response (IVR) systems
- Integrated seamlessly into the HealthFusion® Scheduling module (automates checking based on the schedule)
- Ensures up-to-date patient demographic and insurer information by pulling data directly from participating health plans
- Helps to reassure patients regarding their responsibility almost instantly at the point of care
- Certified as a CAQH CORE Phase 1 Clearinghouse and accredited by EHNAC
- Connects to hundreds of payers.
In order to reduce rejected claims payers, providers and practice management consultants all agree that eligibility and benefit verification should be performed on every patient prior to every visit. Since health plan membership changes every day, verification must be performed by matching the member with the most current payer list or database. Historically, verification was impractical, time-consuming, and costly, since the process involved manually calling the health plan and usually waiting on hold for 15 to 20 minutes.