The EDI•FIED ™ feature provides the customer with further tools to prevent claim denials by the Insurance Payer. Using the EDI•FIED ™ feature, a customer is provided a workable list of non-eligible patients, patients with demographic variances, and patients whose claims will likely result in denial of payment. The tools verify the patient information against the payer data, including patient eligibility, and if insurance coverage is active.
If variances are found, the customer is provided the opportunity to correct these variances in advance of an upcoming patient appointment. Typically, practice management scheduling (PMS) software only identifies if the patient is eligible or not. Often the displayed PMS information fails to identify Medicare Advantage plans, secondary payers, and errors in insurance plan, insurance product, subscriber, and dependent information. Staff time is focused on accounts that require their attention.