Standalone and iSmart integrated Real-time Eligibility services.

The eligibility verification process can take a lot of time. Each payer has its own web portal, where a provider enters a unique log-in and password. In order to check eligibility, a provider has to enter too many patient identification data. If providers can’t access the information online, they need to call the payer, enter more information and wait on hold for assistance.

Checking eligibility is vital because:

It shows if patient can visit an in-network or out-of-network providers;

It determines who is responsible for the bill;

It informs the medical staff about deductible, co-payment and coinsurance;

It helps to warn patients prior to visit about their financial responsibilities according to their plan.

WCH Service Bureau Eligibility eliminates the need for the healthcare provider to spend a lot of time calling insurance companies or searching on their web portals for patient eligibility information.

From our years of experience in the healthcare industry, we know the importance of patient eligibility. It helps prevent denied claims, contributes to accurate reimbursement for the service that you provided and safe time for patient care.

WCH Service Bureau has two solutions for you: 

  • The eligibility service as an integrated part of iSmart Electronic Health Records (EHR) system.
  • Standalone Eligibility service.

Both services have similar workflow and the same eligibility response.  

No more searching multiple payer portals or working through multiple phone prompts to wait on hold for a representative. Now, providers will be able to request more than 700 payers and access active coverage, deductible, co-insurance, co-payment and other information they need from any insurer.

Eligibility service is chargeable and has some rules to follow. For example, to be able to send Medicare request a provider should have enrollment.

The fee is $0.10 (ten cents) to send eligibility request to Medicare and $0.17 (seventeen cents) to send eligibility request to other payers.

Ask your WCH account representative for more information and watch for updates in future issues.