Revenue360 Insurance Eligibility Verification

Insurance eligibility verification

Eligibility Module

The Revenue360 Insurance Eligibility Verification Module initiates a real-time 270 eligibility request at the earliest point in the registration and scheduling process, returning customized 271 benefit information to your revenue cycle team – all based on your hospital specific business rules. Integrated with your hospital information systems, verifying insurance at the point of service allows your staff to collect co-pays and deductibles immediately while improving staff efficiency.

Insurance eligibility verification

Check patient insurance eligibility in real-time for hundreds of payers nationwide!

  • Real-time access to 700+ Payers
  • HIPAA compliant processing
  • Customized, facility-specific response summaries
  • Web-based worklisting & reporting 
  • One-off processing for manual verification
  • Easily look-up historical responses for claim dispute resolution
  • Integrate Pricing Estimation to calculate total out-of-pocket cost
  • Add Payment Processing to process patient copays
  • Find Retroactive Insurance coverage with the ReInquiry Module (RIM)

With Revenue360, insurance eligibility is verified for every patient, every time – improving hospital cash flow & AR days

Revenue360® can connect to any health plan that offers real-time eligibility transactions or website eligibility access. No need to spend additional time on the phone waiting for verification or switching to payer websites to gather the information and re-enter into your registration system. And, no need to wade through the pages and pages of benefit information which slows down registration, creates errors and can delay claim payment.

 Get the Revenue360 270/271 Eligibility Verification Payer List


 Revenue360 integrates directly with any Hospital Information System, including:


Eligibility Verification Advantages For:

Eligibility is often not verified until after the initial patient visit. Without real-time verification while the patient is present, your organization cannot determine and collect co-pays and deductibles at the point-of-service. Revenue360® Eligibility Verificatio n module launches a 270 and returns a 271 at patient admission, pre-admission and/or scheduling without the registrar ever leaving the registration system, or requiring the user to re-key patient information. The result? Reduction of claim denials, decreased A/R days, decreased costs for researching problems and re-submission of claims/bills, and increased front-end collections.

You want your staff to verifiy eligibility on every patient. In order to obtain accurate information, eligibility requests need to be real-time and responses customized so registars only need to view benefit data essential to that visit. How can you ensure that your staff is complying with these requirements?

Revenue360® Eligibility Verification module initiates a real-time 270 eligibility inquiry during the registration process just as soon as the necessary data elements are entered and returns an easy-to-understand 271 customized response. Your staff now has the opportunity to collect co-pay and deductible amounts up front. Revenue360® Eligibility Verification reduces claim denials, shortens reimbursement time, decreases A/R days and improves staff productivity.

Eligibility accuracy is critical to successful registration.  Verifying over the phone or accessing payer websites is inefficient, and rarely happens during the point of registration. Revenue360 Eligibility Verification module launches the 270 inquiry at the earliest point in the registration process, returning a customized, easy to understand 271 response, allowing you to follow the next steps based on your facility’s rules without ever leaving your registration system.  Re-keying information?  Gone.  Waiting on the phone for verification?  Eliminated.  Verification is immediate, automatic, and real-time, freeing you up to attend to your other registration duties.

Fill out my online form.
Provider Advantage’s eligibility solution has helped us to increase upfront collections by identifying co-pays and deductibles for over ten years. Danielle Pieloch

Director of Patient Access, Robert Wood Johnson University Hospital Hamilton

Additional Benefits

  • Reduce Claim Rejections
  • Simplify and Increase POS Collections
  • Identify Medicaid Coverage for Self-Pay Patients
  • Identify & Collect on Retroactive Insurance Coverage
  • Pinpoint Correct Insurance Sequence & Payer Financial Responsibility

Learn More… Download Our Overview (PDF)

Recent Article

Related Blog Posts:

Healthcare CyberSecurity Updates & Guidance

HIT security guidance from the government is in — Social Security numbers are out. We review new Healthcare CyberSecurity updates and guidance guidance as plans for a replacement to Social Security numbers move forward.

read more

Hospital Revenue Cycle Management Challenges and Solutions

Revenue cycle teams have to deal with different challenges – depending on their location, payer & patient mix, and also the services their hospitals provide. However many have identified the same key challenges to maintaining a healthy revenue cycle. What are the most common challenges, and what can hospitals do to address them?

read more

Emergency Department Concerns: Insurance & Patient Satisfaction

Talk about triage. Emergency departments are treating more patients with little understanding of their coverage, and self-diagnosing patients with unrealistic expectations. Patient satisfaction scores are at all-time low and some hospitals are resorting to drastic measures for resolution. What can be done?

read more

Hospital Revenue Growth and Patient Financial Health

While it appears hospitals will continue to see revenue growth through 2016, the cost of care is still a major concern for consumers, and remains a challenge for healthcare executives working to improve revenue cycle results. Improving the revenue collection process at the point-of-service (POS) is a key strategy to improve the overall financial health of a facility.

read more

Narrow Networks 2016 – Health Plans Shave PPOs

Insurers experienced significant financial losses last year and in consequence have shaved PPOs – offering leaner policies. Consumers are now seeing reduced choices via newly formed narrow networks and ACOs. What does this mean for quality of care and patient satisfaction?

read more