Internet-based eligibility verification lowers costs, improves payment timeliness.
Verification of claims eligibility traditionally is performed either through telephone communication between the payer's and provider's staff or through an EDI clearinghouse. These forms of verification offer inconsistent quality, often use out-of-date information, cost time and money, and may financially harm payers and providers by leading to delays in payments or claims denied after care has been rendered. Internet-based eligibility verification software reduces the number of rejected claims because it can access current information without using a clearinghouse. The software also allows earlier collection of copayments because these obligations can be identified accurately when care is rendered. By offering Internet-based eligibility verification, payers can help providers achieve financial benefits while gaining such benefits themselves.
Synquiry Inc., Belmont, Massachusetts, USA. Al71313@aol.com
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Bingham
D001900:Boston; D003361:Cost Allocation; D004608:Eligibility Determination / Q000191:economics*; D005377:Financial Management, Hospital / Q000379:methods*; D007350:Insurance, Hospitalization / Q000706:statistics & numerical data*; D020407:Internet / Q000191:economics / Q000706:statistics & numerical data*; D008329:Managed Care Programs / Q000191:economics*; D009096:Multi-Institutional Systems / Q000191:economics; D019982:Organizational Case Studies; D012984:Software