eligibility

  1. ahasson

    Wiki Termination of insurance appeal

    We've been getting multiple claim denials lately stating that the member's coverage was terminated, usually just a few days before the date of service. We go online to confirm their active status and call for benefits before or on the date of service. We try to appeal the claim and state that...
  2. J

    Wiki Primary Payor Determination - HELP! BH Offices and Beyond

    I need some help please. I am working with some Behavioral Health Offices that are having some issues determining Primary Payors. I am looking for a chart or decision tree or anything that will not only look at Medicare vs Group Health but all payors. Because more often than not we are billing...
  3. J

    Wiki Eligibility Verification

    Does anyone have any good advice on the best way to set up auto-eligibility verification? Any examples of software applications that are really efficient? We are wanting to have an automated process that will generate a report for our persons served receiving Medicaid coverage. We are located...
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