Eligibility Verification

Eligibility Verification

Verify your benefits for a walk-in patient in a few seconds, and print out a customized report ready to hand over. Or download your appointment scheduler with 100 patients and simply upload into NellikkAI™ to get a spreadsheet of Benefits details.

Doing eligibility verification via EHR or a clearinghouse is pretty standardized and needs an expert to decode the EV information that is thrown upon you.

Checking an eligibility for a Service type 30, that is General Plan and Benefits, gives pages of information about various service types, their IN and OUT of network benefits, various CO-PAY and CO-INSURANCE scenarios and whether these CO-PAY and CO-INSURANCE are applicable to their deductible or not. Even more many service types will have a visit restriction per annum, and the visits that have elapsed. The information given by these payors are semi-structured and are scattered around various elements of an EDI 271 file.

Our sixth sense is not attuned to read an EDI document and discern the content. The effort to convert the EDI records into palatable human reading format have been innumerable and the industry does have a few products to accomplish the same. But impregnating the data with intuitive AI before presenting to the user, in a user comprehendible and useful way, is something missing in most of the products available out there in the market.

Our formidable strength of the strong domain knowledge and technology expertise rooting out of two decades of Eligibility Verification have assisted us immensely in developing this module, which helps you get the data, only the data that is required, filtering off the unwanted ones. The system also handles bulk patients with ease and populates the results in a table that is customizable as per your need.

The Patients might have enrolled in more than one insurance and the benefits would have been spread out according to the benefits they are entitled in each. Our intuitive system ensures all those criterions are considered and the claims are done without missing out any.

Our Benefits Verification feature is tailored to your own Practice/Specialty and results are delivered in variety of formats as PDF, Spreadsheet, grid view or directly to your Pre-estimate form; and highlights the exact data that you are most interested in.

The customizable EV rules helps highlight the data that you are most interested in, and guides even the lesser experienced staff to be accurate in reading the benefits.


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Benefits Verified


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