Patient Eligibility

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Real Time Medicare, Medicaid & Private Health Plan Insurance Eligibility Verification – Click HERE for your 5 Free Trials!

Verify your patient’s Health Insurance Eligibility quickly, easily, and inexpensively through our online Medicare, Medicaid & Private Health Plan Insurance Eligibility System.

A great way to maximize payment and minimize errors on www.cortexedi.com

• Eliminate timely phone calls and hold times
• Increase your chances of being reimbursed quickly and efficiently
• Access hundreds of Health Insurance Payers including Medicare, all state Medicaids, all state Blue Cross plans, Cigna, Aetna, United Healthcare, Kaiser, and many more.

What is Health Insurance Eligibility Verification?

Real Time Medicare, Medicaid & Private Health Plan Insurance Eligibility Verification is a fast and secure method to instantly retrieve patient insurance information from over 400 Health Insurance Payers from a single point of access including:

• Coverage Information
  Use Cortex EDI Medicare, Medicaid & Private Health Plan Insurance Eligibility Verification to get information about services for your patients. Medicare responses will receive Medicare Part A and Medicare Part B Entitlement/Term Dates.
• Patient Information
  Retrieve patient information including patient address based on Payer’s records.
• Primary Insurance Information
  Find out the primary insurance information if Medicare is the secondary payer.
• Deductible Amounts
  Get the Dedictuble amounts applied and remaining per year for each Coverage Level.
• Co-payment Amounts
  Get the Co-payment amounts required for each Service Type. (In and Out of Network).
• Out of Pocket (Stop Loss) Amounts
  Determine the out of pocket (stop loss) amounts for each Coverage Level and Service Type for plans in and out of network.
• Co-Insurance Amounts and Percents
  Get the detailed Co-Insurance Amounts for each Coverage Level and Service Type.
• Limitations
  Determine the patient’s medical coverage limitations.
• Determine the patient’s Primary Care Provider
  In some cases, the payer will give you information about the patient’s Primary Care Provider, including physician name and phone number.
• Hospital Data
  Get Hospital Days Remaining and Hospital Coinsurance Days Remaining.
• Skilled Nursing Facility Data
  Retrieve Skilled Nursing Facility Days Remaining and Coinsurance Days Remaining.
• Home Health and Hospice Data
  Find out if your patient has had a Home Health Episode, or a Hospice Episode, and the dates of those episodes. Also gives information about the Payer for those episodes.
• Medicare Part D Data (Pharmacy)
  Receive patient’s Pharmacy Plan Name, Contract Number, Plan Number, Phone Number and Enrollment/Dis-enrollment Dates.
• Medicare Secondary Payer and Medicare HMO Data
  If patient has Medicare Secondary, or HMO Plan, you will see the Plan Name, Contract Number, Plan Number, Phone Number and Enrollment/Dis-enrollment Dates.
• Physical, Speech, and Occupational Therapy Data
  Find out the patient’s cap amount for Physical and Speech Therapy, and Occupational Therapy.
• Updated Medicare Insured ID
  Receive patient’s updated (current) Medicare Insured ID when submitting patient’s old Medicare Insured ID.
• 24/7
  Online system available 24 hours a day, 7 days a week.
• Seconds
  Automated response returns in just seconds.
• All States
  Available in all 50 states in the US, and US Territories.
• And Much More…
  Much more valuable information about the patient is revealed, according to the individual Insurance Payer.

Batch Medicare Eligibility Verification is now available.
You can send a batch of requests and receive responses as quick as a few minutes later, depending on the number of requests.

Call Cortex EDI for more details at (800) 485-5977 or email support@CortexEDI.com.