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by daigoba66 4854 days ago
Healthcare providers in the US are paid by insurance companies. It is incredibly useful for providers to know if the patient that just walked-in for service actually has eligibile insurance benefits for the services about to be delivered. Historically this is done via phone calls and fax, if done at all.

There are ANSI standard EDI transactions designed specifically for healthcare insurance eligibility inquiries (there also exists transactions for claims, but that's the other side of the puzzle). The standards themselves are pretty simple. But unfortunately, from a business development and integration perspective, the effort required to become trading partners with healthcare insurance companies is extremely high. There are plenty of vendors and clearinghouses out there which make the process easier. But this company is trying to make the setup and integration even easier with self-service sign-up and credit card billing. It's a novel idea.

Edit: I have no affiliation with Eligible but I've been working with the underlying technology for many years.

1 comments

Thanks. You answered what Eligible does much clearer than the Eligible guys (and gals :) ) themselves.

It does look very useful :)

thanks for the gals!