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Eligibility "Hot Line"

“Is the Patient eligible?”
“Do we need treatment authorization?”

“Well…it’s 5:00, I’ll check it tomorrow.”
Or
“Well…it’s Friday, I’ll check it Monday.”

States and HMO’s have made millions of dollars from just such statements. More and more States are requiring treatment authorization within 24 hours of seeing the patient. Many HMO’s are even making it tougher than this. They say you have to notify them within 12 hours or the claim will be DENIED.

You don’t have time for this…but we do!     Here’s how it works:

  1. Call our Free 24/7 Eligibility “Hot Line”
  2. Give us the basics about the patient
  3. Hang up
  4. We call the State to verify Eligibility and Authorization requirements
  5. We call the HMO and Notify them of the ER visit
  6. We call the PCP and get the Referral Authorization
  7. We call you back with a Confirmation number and eligibility status
  8. You send us the claim
  9. Claim gets Paid
Now that sounds better!

 

   
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