Eligibility posts

Health insurance and healthcare payer resource for articles, case studies, whitepapers, insights, research, advanced solutions and tools on eligibility audits and reviews

Eligibility data management: Fixing payment integrity at the source

With all of the demands on your team, your time, and your resources, eligibility data management may not be your first priority. In our experience with over 15 health plans, eligibility data issues are the root cause of between 20% and 30% of payment integrity costs.

The right eligibility data management solution

Addressing eligibility data management can seem like an overwhelming or impossible task among all of your other competing priorities. However, fixing these data errors can eliminate downstream impacts to your payment integrity programs that are likely costing your plan millions of dollars.

The eligibility impact: How and why eligibility data issues affect payment integrity

Over the last two months, we’ve examined how organizational and technology structures can keep health plans from recognizing, understanding, and resolving their payment integrity challenges. This month, we want to spend a little time examining one thing that can be at the root cause of some of those challenges: eligibility. Eligibility issues impact a multitude

Whitepaper: Innovations in cost containment for healthcare payers

Increase savings and recoveries with information-driven cost containment solutions. Today’s most successful cost containment solutions are information-driven and automate many processes that are otherwise manual and time-consuming. By combining advanced technology such as data mining and cloud computing, with information analytics and improved business processes, this new generation of “intelligent” cost containment solutions enables health

Discovery Health Partners expands offerings with Eligibility Solutions

New Solutions Validate Eligibility Data with Speed, Efficiency and Minimal Impact ITASCA, IL (September 17, 2013) – Discovery Health Partners today announced that it has expanded its Intelligent Cost Containment solutions portfolio with new Eligibility Solutions that enable faster, simpler collection and sharing of eligibility data among payers, providers and employers.  These Eligibility Solutions focus on