It is more important than ever to make sure you are eligible to see a patient. If not, your claims will be denied and in
many cases you will not be able to bill the patient either. There are several ways to perform Eligibility Verifications. The
most effective solution however, is Electronic Eligibility Verifications. Its fast, very easy to perform and very inexpensive.
Eligibility verification responses include a lot of information including coverage, co-pays, deductibles, etc. Listed below are
the different Eligibility Verification options.
Free Eligibility Verifications
Most insurance companies offer free on-line eligibility verifications by logging directly onto their websites and performing
an eligibility verification for each patient one at a time. (or you can call them to find out) This method becomes even more
in-efficient when patients have different insurances, requiring you to go to each carrier’s website separately to perform the
eligibility verifications. This method might be beneficial in some cases, but is very time consuming and inefficient over all.
Practices using this method tend to perform fewer (if any) eligibility verifications. In addition, each carrier presents the data
in different formats, making it harder to find the relevant data each time.
Manual Eligibility Verifications Via Our Clearing House (Zirmed)
Another more efficient way to perform eligibility verifications (compared to going to each insurance company’s website
or calling them) is through a single website – Zirmed. If you will not be using an appointment scheduler with integrated
eligibility verification capabilities, this will probably be the most efficient and effective way to perform them. The
information is provided in one uniform format regardless of the carrier, making it easy to find the relevant data you are
The most Efficient Method – Eligibility Verifications Via Our Appointment Scheduler (Healthpac)
Our billing software system (Healthpac) has its own integrated appointment scheduler. (See separate “Appointment
Scheduler” section for features and benefits of using it) Our appointment scheduler can process eligibility verifications
both individually (manually, on-demand) and/or in automated batch mode. In automated batch mode (the most efficient
way to perform eligibility verifications) you can set up the scheduler to run eligibility verifications for all the patients
scheduled for a particular day 24 or 48 hours in advance. This way, you can review the results before patients come in
and make the necessary adjustments. (Have the patient provide different insurance, secure cash payment, re-schedule or
cancel the appointment, etc)
For More Information
Contact Ashron Billing at (818) 704-4301