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Responses for insurance eligibility and verification
Posted By: captnkw on January 6, 2017
Thank you all for all of the great and speedy responses!! Here are most of them. Seems like the consensus is Zirmed, Navinet, and Availity. 1. Off the top of my head Availity and Navinet are two large companies of which you could review. I use them for some of the 'free' verifications they offer. I believe one, if not both of them, offers paid subscriptions as well for access to more insurance providers. 2.I have used both ZirMed’s eligibility system and NaviNet. I currently use and prefer Navinet. Navinet runs $25 a month for every insurance company they have access to, which is most. I do not use it for Medicare, I prefer the Medicare Portal. I input the deductible and out of pocket limits into OPIE’s Insurance verification form and run a service estimate for the Lcodes that had been selected. (I have most of the common insurance company’s fees schedules in the system) Then create a Financial Responsibility form in OPIE to show what the patient would owe. I collect half of what their out of pocket will be after Eval and the other half at delivery (I re run numbers right before delivery to make sure nothing has changed; I do not want to have to refund them after claim processes). 3.If they need to break it into more payments then I do that, but I put it in writing on my Financial Form and have the patient sign what we have agreed to. We use Square for patient CC payments and we also offer Care Credit 0% financing. Care Credit has been great for increasing up from collections and not having to bill patients each month. They get 0% with Care Credit, and I get paid at time of service from Care Credit. No monthly billing for the patients, they pay Care Credit each month. 4.I believe my staff uses www.availability.com They have most of the major insurance companies all in one place. I also set them up for the CMS portal (myCGS for region C). 5.I think you'll find that everyone else is doing what you are doing. I'd be reluctant to trust a central clearinghouse anyway just because being one step removed from the payor, their information would be less up-to-date than the payor themselves. 6.Our practice utilizes patient verification through Zirmed for all of patients. They also offer Patient Estimation and Patient Payments. All of these services are great! https://public.zirmed.com/ 7.I believe Availity is free, it's a great source. as is Navinet. If you want to spend money, Zirmed is good. 8.We use Availity Web Portal. You may call Availity Client Services at 1-800-282-4548 <(800)%20282-4548> to request how your office may set up an account. They can tell you the insurance companies they have. I would look into Zirmed. They provide a wealth of knowledge in eligibility. We also use them as our billing clearinghouse. They have great logistics and reporting ability. 9.Navinet is what we use in Pennsylvania. 10.We changed clearing houses to Zirmed. We can verify eligibility, submit, and correct claims if necessary all in one place. It takes a lot of time and work to set it up but it's worth it. I can also check most of my carriers on Navinet. We are required to obtain precert requests for some carriers through Navinet which you cannot do through Zirmed. Navinet offers most of the common carrier searches for free and some like Medicare and United you have to pay for. 11.Your clearinghouse should offer that service to you. 12.Availity has several companies Anthem blues cigna UHC ect Thanks again! -- Kirk R Wise LPO, CPO Lima Brace & Limb 1000 Bellefontaine Ave Lima, Oh 45804 [E-mail Address Removed] www.limabraceandlimb.com 419.224.4841 fax 419.228.8138 |
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