How do you connect to an insurance company, to know your patient’s policy coverage?

Many call the insurance company to verify the patient coverage, but do you know there are EDI transactional policies to automate your process?

Know about EDI 270 & 271:

As the patient entries for critical treatment, it is necessary to know the eligibility and benefit covered for your patient. Once you are an EDI compliant organization, you are required to submit the electronic transitions to your insurance company.

To inquire about the eligibility benefit, EDI 270/271 transaction set is initiated by the health service providers, such as hospitals or medical facilities, to the insurance companies or government agencies. The 270 transaction inquiries about the services covered like policy subscribe, dependents, copay, coinsurance, etc. Used to enquire about a generation or specific information coverages, it includes the details of name of the sender, name of the recipient, details of the plan, description of requested eligibility. EDI 270 is used to enquire about the plans covered whereas the EDI 271 transaction sends the response. The 271 health care eligibility/benefit response transmits the information requested in 270. In contrast to the information requested on phone calls, EDI 271 transaction provides detailed information about the coverage enjoyed by the patients.

Why use EDI 270/271 transactions?

Information provided using 270/271 transactions is much more than obtained from the traditional methods of phone calls and papers.

EDI 270/271 transactions are fast, it allows you to get information without the patients’ intervention. Reduced paperwork and rework, the service provides are allowed to submit the same inquiry to multiple insurances to different provides. EDI transactions ensure healthcare service providers are HIPAA compliant and for more information on EDI 270/271 transactions and HIPAA-compliant contact us or mail us.