Sandata Introduces Eligibility Service to Improve Providers’ Revenue Cycle Management

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Sandata introduces Eligibility, a new service, to address the number one source of claims rejections and denials: ineligible patient insurance coverage. By supporting providers in checking eligibility more frequently, Sandata can greatly improve their revenue cycle performance, thus maximizing revenue and cash flow. The service is powered by Eligibill, a proven and cost-effective way to manage this critical process.

At this time, Eligibility is available to Sandata’s home care and I/DD provider agencies. The service can perform batch and individual client checks via secure upload. It’s a user-friendly process that doesn’t require staff to manually check payer websites or manage EDI (Electronic Data Interchange) inquiries and responses. It also offers flexible reporting formats.

“We want to empower our providers to collect for all services they provide,” said Phil Feldman, VP of Revenue Cycle Management. “Eliminating claims rejections and denials is a direct way we can help.” The Eligibility service works with Medicaid, state and county programs, and managed Medicaid (Managed Care Organizations).

Eligibility is a complement to Sandata Revenue Cycle Management (SRCM) services, which focuses on improving a provider’s cash flow and increasing revenue. The SRCM service works with Medicaid, state and county programs, managed Medicaid, commercial insurance, VA, certified agency and facilities contracts, long term care insurance, Medicare Advantage, and self-pay. On average, SRCM collection rates are 99.2% of provider billing.

“For providers using Electronic Visit Verification, having expedient access to eligibility information will further drive results due to correctly identifying the payer, confirming benefits eligibility, and obtaining authorization for services” explains Feldman. Sandata brings greater insight to the entire process, making SRCM a service far beyond billing and collecting.

Interested providers should visit sandata.com and schedule a call to learn more about how Eligibility and SRCM can address their revenue cycle management challenges. With experts at Sandata ensuring higher cash flow, on-time claims, and more, providers can focus on giving great care.

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