Real Time Transactions

Eligibility

One of the main causes for claims rejection or denial is patient insurance ineligibility.  E*HealthLine’s integrated system determines the patient’s insurance eligibility prior to rendering service. The System accesses critical patient and insurance information including coverage dates, deductible amounts, co-pays and more in real-time or batch modes.

E*HealthLine’s eligibility system integrates with many leading practice management systems, providing automated eligibility verification and crucial patient eligibility information which populates key fields within the Practice Management system.

E*HealthLine Eligibility System Provides:

  • Reduce costly rejections and denials – eligibility verification before patients are seen
  • Increase profitability – reduce costly write-offs
  • Improve staff productivity – eliminate manual eligibility verification
  • Increase cash collections – obtain up to date co-pay, co-insurance and deductible information
  • Receive real-time access to critical patient and insurance information, including coverage dates, benefit ceilings, co-pays and more

Claims Status

Claims Adjustment

Secondary Claims Processing

The secondary carrier supports automatic crossover of claims, simplifying the processing:

  • Facilitates the requirements of payers  who do not accept ANSI 837, by creating a secondary HCFA and a “mock” EOB, which can be printed with a page break between patient-specific information and sent to the payer
  • Enables on-line storage for instant viewing and sorting of EOBs input from the E*HealthLine application
  • Generates customized reports utilizing filters to include check dates, check numbers and all specific required data.

Patient Responsibility Estimator

E*HealthLine’s suite of innovative applications offerpatient billing and payment solutions that assist in streamlining the billing process and overall management of the patient’s payment. These solutions minimize processing costs and reduce time in dispensing statements to the patients, while accelerating the collection of payments.

Fee Schedule

Pharmacy Services

E*HealthLine’s Pharmacy Services simplifies the prescription process and increases efficiency, accuracy and profitability for customers ranging from chain and community pharmacies to payers and prescription benefit managers.

Prescription Benefit Administration

E*HealthLine simplifies prescription benefit programs and provides a higher level of efficiency, accuracy and profitability.  The company’s extensive integrated network provides unsurpassed pharmacy claims adjudication, data warehousing and ancillary administrative services, enabling improved claims processing efficiency and comprehensive financial transparency for the overall management of prescription drug expenditures.

Productivity solutions analyze the claims data and permanently eliminate the cause of rejections and denials, improving overall financial performance.

Reporting

E*HealthLine’s analytic tools enable spot rejection and denial trends, creating process changes, while tracking meaningful results.

Optimized Claims Processing

  • Identify and rectify the cause of  data / claims rejection  by  each department
  • Customize workflow to identify systematic problems
  • Analyze rejections by category and function: patient demographics, eligibility, coding, etc.
  • Obtain valuable data  regarding the criteria of rejections as they occur calculate the financial impact  and the  processes which  improve the overall outcome by month, quarter or year-to-date

Prioritize Claims For Maximum Revenue

  • Sort claims by rejection, denial code, payer, location and provider
  • Quickly identify and fix errors in high-dollar-value claims for resubmission
  • Proactively manage outstanding claims,  avoiding cancellation due to failure to file in a timely manner

Alerts

E*HealthLine’s Alerts proactively identifies and highlights the cause of claims problems:

  • Identify claims that exceed aging limits
  • Monitors and interrupts the aging of rejections
  • Manage and avoid timely filing denials

E*HealthLine Patient Payment Solutions™

E*HealthLine’s Patient Payment Portal Provides Cost-effective Solutions

  • Increased cash flow
  • Improved patient satisfaction with clear and concise patient statements
  • Reduced processing costs,  consolidating patient statements
  • Increase staff productivity