Enhanced Eligibility Service with ERA Integration
Explore the recent enhancements in the eligibility service.Experience seamless eligibility check integration with Drive Three Sixty.Leverage powerful data for crucial billing decisions in clinics and for physicians.
Step 1: Use the service to determine if a patient's treatment is covered by their insurance.
Step 2: Track covered visits and prior authorization requirements.
Gain insights into expected patient responsibility components such as co-pay, coinsurance, and deductible.Understand that the current eligibility implementation relies on data from service partners, ClaimMD, and Pwify.Acknowledge the variations in plans across numerous payers.Recognize the challenges in extracting benefits for each case.To enhance eligibility check accuracy, Spry integrates data from RCM.The new version's highlight is its integration of data from ERA for more detailed information on benefits and coverage limitations. ERA data, reflecting actual reimbursement from the payer, is a reliable source. It confirms patient data accuracy, indicates higher claim approval certainty, shows the co-pay in point six percent, helps determine if the deductible is exhausted, tracks if the out-of-pocket limit is reached, and identifies if prior authorization is needed or if the Medicare cap is exhausted.
Step 1: Navigate to the appointment dashboard and book an appointment.
Step 2: Open the new appointment and proceed to the insurance info.
In the insurance info section, view all the patient's insurance cards. Each card has an option to check eligibility details.Click on the option to view eligibility benefits and limitation information. Notice the new button to access the newer version.In the newer version, observe the patient's coinsurance percent and copay amount.Question the difference in data between versions.Understand that the difference arises from integrating data from ERA. In the patient's reimbursement history, find an ERA. Review the ERA details.Notice that the ERA details are reflected in the newer version, enhancing the eligibility service's accuracy.