EDI streamlines reporting requirements for Medicare managed care.
Using automated eligibility verification tools for Medicare patients can help providers submit clean claims to managed care plans as well as file secondary claims efficiently to fiscal intermediaries. Automated eligibility verification systems combine EDI tools and data-processing software so providers can access databases to secure all the correct information before billing. In addition, an insurance eligibility system can automatically post benefit information to patient account files.
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QuadraMed Corporation, Portland, OR, USA.
D014487:Centers for Medicare and Medicaid Services, U.S.; D003625:Data Collection; D001330:Electronic Data Processing; D004608:Eligibility Determination / Q000458:organization & administration; D007345:Insurance Claim Review / Q000458:organization & administration*; D008329:Managed Care Programs / Q000458:organization & administration*; D006278:Medicare / Q000458:organization & administration*; D014481:United States