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:

  • HeW's browser-based application provides access to benefit information and receives responses to electronic eligibility inquiries directly from health insurance carriers.

  • Batch eligibility verification is a custom solution enabling clients to submit a patient roster from their host system and receive updated eligibility information in a customized format prior to rendering services.

  • Custom interface eligibility verification interfaces with the clients host system to verify patient eligibility.

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Address Verification and Patient Financial Summary

HeW understands our clients revenue cycles are dependent upon the patients that flow through their organizations. The HeW Address Verification and Patient Financial Summary solutions allow clients to verify patients' personal information and assess financial integrity at the time of services.

By cross-referencing patient demographic information with TransUnion, HeW delivers a comprehensive solution to enhance financial counseling and collection processes. As a result, clients experience reduced errors in self reported information, increased self-pay collections and reduced bad debt.

The HeW Patient Financial Summary enables informed decisions related to:

  • Identification Accuracy: Including name, date of birth, social security number and address.

  • Probability of Financial Aid: 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 and/or the full Financial Assessment.

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Medical Necessity Verification

HeW clients can verify Medical Necessity prior to services being rendered, reducing rick of uncompensated services and confused patients.  The HeW system can be implemented using a convenient web interface, or via a custom interface with any provider system.


  • Verify medical necessity prior to rendering services

  • Print CMS approved ABN


  • Reduce uncompensated services

  • Improve self-pay collections

  • Increased patient satisfaction

Patient Impact:

  • Patients gain increased understanding of what their insurer may cover and their personal liability for services rendered

  • Ability to make decisions based on clarity and informed choices

  • Convenience and value placed on patient's time

  • Fewer payment rejections and errors increase patient satisfaction

  • Increased confidence in the provider contributes to patient loyalty and positive word of mouth.

Click here to download a full brochure.