Payer Connection, LLC announced that State of Oregon’s Division of Medical Assistance Program has been added to its eligibility center, a portal module that services eligibility requests for participating payers. The State of Oregon insures over 400,000 members at any given time and now customers signing up for the eligibility center can verify member eligibility before rendering services.
“The state of Oregon began offering a real-time eligibility web service for 270/271 eligibility requests at the end of last year, stated Dean Hill, President of Payer Connection. “As part of HIPAA compliance mandate, they also stopped servicing eligibility requests from their proprietary OLGR, OLGX, and OLM screens. This left the users of these applications searching for alternatives. Our portal application sends a 270 [eligibility] request to the state that responds with a 271 [response]. Since the response is from their live system, the information is as accurate and reliable as if you actually called the state, “ he continued further.
“We initially developed this integrated service for our OMAP Managed Care Organization customers who used these screens daily to verify enrollment from the state, “ stated Jamie Chesak, System Architect of the TrinEDI system. “Because the state “farms” out coverage of its population to over 20 different MCO’s, its sometimes hard for providers to determine whether claims should be sent to the state for FFS (fee for service) payment or to the MCO responsible for the patient. With this new eligibility service, billing personnel can verify a patient’s coverage for both scenarios,” he added.
About Payer Connection
Payer Connection is committed to improving the business of healthcare administration. Our products and services eliminate much of the daily paperwork and “phonework” that burden office staff. We build on emerging HIPAA electronic transaction standards to enhance the business success of practice management.
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Whether you are a Provider, Payer, Employer, or Systems Vendor, we understand your perspective and have built a solutions to bridge the communication gaps that exists within the healthcare delivery system. Solving the administrative bottlenecks today will allow for more time and energy to be spent on the clinical and patient care aspects of your operations.