Eligibility & Patient Access

A real-time solution that provides patient profile and benefits insights at the point of service to ensure appropriate care delivery, as well as efficient and accurate reimbursement.

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Complete Patient Access

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Access real-time eligibility and benefits information for providers to ensure appropriate payments are made and received by all parties.

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Effectively manage referrals and prior authorizations to achieve improved patient access, as well as reduced administrative and medical costs.

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Increase cost savings for payers and providers by ensuring accurate eligibility benefits information at point of service and efficiently managing member data.

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Conduct automated eligibility transactions early in the process to help improve claim accuracy and associated cost savings.

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Immediately communicate if a patient is eligible for the service being considered, including referrals and prior authorization needs.

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Experience a seamless workflow by having real-time transactions driven from existing technology platforms.

Achieve Total Transparency in Benefits

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Provider self service

  • Reduce costs by establishing benefit eligibility at point of service to ensure appropriate care is delivered and reimbursed. Real-time transactions are accessed with either a direct or hosted connection. 
  • Serve your provider networks in the best way possible with the availability of comprehensive member eligibility data. Real-time transactions are driven from existing technology platforms for seamless workflow.
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Regulatory compliance

  • Facilitate regulatory compliance by connecting to virtually any system for all payer-to-provider HIPAA-mandated transactions with Change Healthcare’s nationwide network. 
  • Government benefit reporting mandates and facilitates HIPAA and CORE compliance. Our clearinghouse is also ENHAC certified.
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Broad connectivity

  • Leverage the broad access of our Intelligent Healthcare Network™, which connects 800,000 physicians with 2,100 payers, to effectively expand your connectivity.

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