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Payment Assurance 

Eligibility Verification

By assessing and understanding patient benefit entitlements, HeW clients experience fewer denied claims, reduced A/R days and an enhanced patient account management process.  HeW clients can validate patient eligibility prior to admission, or rendering services, through the following methods:

• Real-time eligibility verification is available by accessing benefit information through HeW’s browser-based application by receiving the response to electronic eligibility inquiry transactions from select Health Insurance Carriers. The level of detail available in these transactions is determined by each Health Insurance Carrier.  
  
• Batch eligibility verification is a custom solution available that enables clients to submit a patient roster from their host system and receive updated eligibility information for those patients prior to rendering services.  HeW Clients can receive eligibility data in a customized format to review or upload to their host systems. 
  

• Custom interface eligibility verification is a custom solution that interfaces with the clients host system to verify patient eligibility within the host system.

Address Verification and Patient Financial Assessment

HeW understands our clients revenue cycles are dependent upon the patients that flow through their organizations. The HeW Address Verification and Patient Financial Assessment solutions allow clients to verify patients’ personal information and assess financial integrity at the time of services. By cross referencing patient demographic information with the trusted credit reporting agency TransUnion, HeW delivers a comprehensive solution that will enhance financial counseling and collection processes. Allowing clients to experience reduced errors in self reported information, increased self-pay collections and reduced bad debt. The HeW Patient Financial Assessment will enable better informed decisions in the following areas:

• Identification Accuracy: Verify patient demographic information including Name, Date of Birth, Social Security Number and Address. 
  
• Probability of Financial Aid: Simplify and standardize your processes to determine a patient’s eligibility for local, state and federal financial assistance programs. 
  
• Likelihood of Collection: Review financial measures including; available credit, residual income, debt-to-income ratio and the percentage of federal poverty level.

Clients may choose to receive only the Identification Accuracy (Address Verification) and/or the full Financial Assessment.