Medical Eligibility Verification

Minimize a Leading Cause of Claim Denials with Eligibility Verification

Ineligible patient insurance coverage is one of the leading causes of payer claim rejections and denials. ZirMed’s Eligibility Verification solution provides customizable and easy-to-read payer responses. Beyond insurance eligibility verification, ZirMed includes co-pays, deductibles, inpatient days used, and other pertinent benefit data. Armed with this information, you’ll be able to make payment arrangements and increase collections prior to rendering services.

Leverage Rich and Actionable Eligibility Responses

ZirMed’s Eligibility Verification solution offers real-time connectivity to more than 1,200 payers, enabling a streamlined workflow from a single, intuitive view of each patient’s insurance information. ZirMed’s proprietary service-type code mapping yields richer and more accurate eligibility responses. ZirMed also normalizes all benefit responses, resulting in a single, easy-to-read format regardless of payer.  ZirMed can also customize methods of inquiry for medical eligibility verification, response display, and more to provide a personalized user experience for your organization.

Use Batch Processing for Insurance Eligibility Verification

Achieve substantial  time savings by performing medical eligibility verification in batched files. ZirMed’s Eligibility Verification solution increases your productivity by reducing the research time required to delve into individual patient coverage by providing real-time batch inquiries. ZirMed’s scheduled batch upload capability allows you to identify each patient’s coverage status, including the ability to check Medicare eligibility verification, days before their appointments.

Increase Cash Collections

When you can obtain up-to-date co-pay, co-insurance, and deductible information, you can increase cash collections. By coupling ZirMed’s medical eligibility verification solution with ZirMed’s Patient Payment solutions, you can collect patient responsibility right from the eligibility inquiry. With the click of a button, you’ll have the ability to take a credit card payment, an ACH payment directly from a patient’s bank account, or log a cash payment.

Integration Capabilities

By design, ZirMed’s revenue cycle management platform enables creators of healthcare technology solutions to seamlessly and easily incorporate our HIPAA and PCI-compliant applications and transactions into your software solutions. Using ZirMed’s integration capabilities, organizations seeking a traditional approach of exchanging EDI transactions may transmit and receive a variety of claims, payments, eligibility inquiries, and other healthcare transactions using established technologies and methods such as X12 files, APIs, Flat Files, FTP, Encryption (i.e. PGP), and more. You’ll have confidence knowing that your exchanges are occurring securely, in compliance with all regulatory guidelines, and utilizing existing technological capabilities.

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