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Eligibility Verification

Patient eligibility is one of the important challenges facing providers today. Most providers complete only as many eligibility verifications as their staff have time for 1-800 phone calls. The eligibility of half or more of all patients is typically not known until receipt of an EOB weeks after the date of service. Approximately 6% of all claims are denied due to ineligibility and less than 50% of patient pay receivables are collected.

ProIdentify solves this problem by delivering critical eligibility data to your desktop in a matter of seconds using a standard web browser. This allows you to collect appropriate funds from both patient and payer or make financial arrangements before service is rendered.

ProIdentify Features:
  • All-payer real-time access from a single secure website

  • User-friendly interface presents eligibility responses in plain English

  • Single patient or batch requests; standalone or POMIS integrated

  • Optional ELSEE™  Eligibility Search Engine™ searches multiple likely payers for eligibility                when supplied info is invalid

  • ProIdentify eliminates
  • Waiting on hold for verifications

  • Accessing multiple payer websites for verification

  • Eligibility-related financial losses

  • ELSEE™ Eligibility Search Engine™
    When a patient’s payer information is invalid, often this is simply a result of an outdated patient file, errors in supplied information, new carrier due to a change of employment or other reason. ELSEE is Veredi’s proprietary eligibility search engine that attempts to find valid eligibility from the payers most likely to provide coverage for that patient based on regional and other factors. A substantial percentage of problem cases can be converted using this tool. ELSEE can reduce the need to contact patients for insurance information, minimize staff time and financial losses.

    © Copyright 2006, Veredi, Inc.