Eliminate timely phone calls and hold times
Maximize payments and minimize errors
Access hundreds of Health Insurance Payers
Increase your chances of being reimbursed quickly and efficiently
You can send a batch of requests and receive responses as quick as a few minutes later, depending on the number of requests
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.
Find out the primary insurance information if Medicare is the secondary payer.
Get the Co-payment amounts required for each Service Type. (In and Out of Network).
Get the detailed Co-Insurance Amounts for each Coverage Level and Service Type.
In some cases, the payer will give you information about the patient’s Primary Care Provider, including physician name and phone number.
Retrieve Skilled Nursing Facility Days Remaining and Coinsurance Days Remaining.
Receive patient’s Pharmacy Plan Name, Contract Number, Plan Number, Phone Number and Enrollment/Dis-enrollment Dates.
Find out the patient’s cap amount for Physical and Speech Therapy, and Occupational Therapy.
Retrieve patient information, including patient address based on Payer’s records.
Get the dedictuble amounts applied and remaining per year for each Coverage Level.
Determine the out of pocket (stop loss) amounts for each Coverage Level and Service Type for plans in and out of network.
Determine the patient’s medical coverage limitations.
Get Hospital Days Remaining and Hospital Coinsurance Days Remaining.
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.
If a patient has Medicare Secondary, or HMO Plan, you will see the Plan Name, Contract Number, Plan Number, Phone Number and Enrollment/Dis-enrollment Dates.
Receive patient’s updated (current) Medicare Insured ID when submitting patient’s old Medicare Insured ID.
Automated response returns in just seconds.