This API uses a comprehensive dataset of eligibility records from multiple health plans, supporting more accurate and efficient claims processing. Our solution helps determine the order of coverage, reducing information gaps that can lead to billing errors, eligibility denials, and recovery cycle inefficiencies.
By identifying the correct primary payer before claim submission, our solution helps reduce eligibility errors, alleviate administrative rework associated with claims processing, and minimize unnecessary overpayments and rebilling processes.
Our real-time capabilities reduce payment delays caused by COB errors, so providers can get paid faster.
A: Yes! We encourage you to use our sandbox environment before signing a contract. The login requires a separate set of credentials that you can get from your Starter Guide. After receiving your client_id and client_secret for our sandbox environment, you can test the API in our interactive documentation, an application like Postman, or test the APIs using your own development console before making any commitments.
A: The key benefits for providers include the ability to remediate COB errors before claim submission — reducing claim denials and reducing the administrative burden associated with post-pay offsets and rebilling.
A: The eligibility check process uses an API call to a member data store based on the current technology that will be used.
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