Eligibility Curator

Today’s verification challenges warrant the Wave Analyzer.

The scale of the problem providers face is best illustrated by the outsized back offices they employ to edit claims and generate appeals. One big reason is that, unlike Wave HDC’s tool, most clearinghouses merely verify but don’t check for active and billable coverage and the associated accurate benefits. Your staff then ends up dealing with the fallout on the back end.

Many providers find that their supposedly automated verification solutions still require lots of manual work. With our tool, automated means automated. AI finds and analyzes, IA figures and determines, and RPA executes the fix.

That’s the Wave Analyzer at work.

Enhanced verification provides exceptional value to your RCM.

Wave HDC’s Eligibility Curator enables providers to check a patient’s eligibility status with multiple insurances simultaneously. It brings back results in real-time for all payers, including advanced chaining, primacy, and routing. Furthermore, it brings back benefits down to the plan level without having to log into portals.

Superior data and AI-powered automation—that’s the secret.

The Eligibility Curator’s exceptional performance is due to the Wave Analyzer as well as our investments in connectivity that ensure the highest quality continuous source of data. Rich data, intelligently curated enables users to verify patient coverage, including copays, coinsurance, and deductible information, at any point in the patient continuum—from pre-service through appeals. Accurate upstream data helps avoid processing errors, eliminates costly re-works and dreaded calls to payers, and lowers billing and collections costs. All of this ultimately accelerates the conversion of receivables to cash.

Get over-and-above eligibility data for over-and-above results.

This tool automatically interrogates 271 responses, indicating any secondary or tertiary coverage data. It adds Medicare Beneficiary Identifiers (MBI) as needed and continuously updates the records in your host system. Automated enhancements like these provide tremendous value on the back end, requiring less manual work to make corrections later. So staff can focus their attention on appealing denied claims or patient or payer follow-up.

Our eligibility benefits are as good as it gets.

• A/R benefits: cut off delays and claims denials through automated updates and corrections
• Workflow benefits: reduce staff time editing claims and appeals
• Collections benefits: reduce collection and billing costs through continuously updated patient records
• Data source benefits: leverage our connectivity to the highest quality available
• Over-and-above eligibility benefits: active and billable coverage, plan level detail, chaining, and primacy
• Reporting benefits: ability to attach a cost per claim to fix
• Monitor self-pay accounts for retro conversions and save timely rework while helping your DSH statistics
• Opt for deductible monitoring and hold claims until the earlier of a deductible reaching $0 or timely filing limits

Choose an automated RCM tool that doesn’t make you finish the job.

Unlike competing solutions, our tool doesn’t force workarounds that diminish your staff’s productivity and inject the possibility of errors into processes. Ensure your medical insurance verification software partner provides an end-to-end solution to ensure every episode of care results in proper claim submission.