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Insurance Eligibility

Verify insurance eligibility and benefits for proper reimbursement

TransUnion Healthcare Insurance Eligibility checks patients’ eligibility and benefit levels automatically via access to more than 400 payers across the U.S., as well as a number of automated and integrated insurance eligibility services.

Benefits of Insurance Eligibility:

  • Decrease claims denials
  • Increase reimbursements
  • Lower accounts receivable
  • Avoid costly manual verification calls
  • Improve practice management efficiency

Improve your processes with minimal changes to your existing systems

  • Step 1:
    • Patient identity and insurance information is sent to TransUnion Healthcare via a standard EDI transaction from your patient registration system.
  • Step 2:
    • Benefit eligibility inquiry (HIPAA ANSI X12 270) message is transmitted to patient’s insurance company.
  • Step 3:
    • Benefit eligibility response (HIPAA ANSI X12 271) message is returned by insurance company.
  • Step 4:
    • Coverage and benefit information is integrated into your patient registration system via a standard EDI process. In addition, coverage and benefit information can be viewed via the MedConnect portal if integration is not available.
Easily integrate TransUnion Healthcare Insurance Eligibility into your existing pre-service processes.
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