Misys FastEligibility
Electronically validate patient eligibility
Misys FastEligibility enables you to electronically validate a patient’s eligibility from within the Misys Tiger practice management system, eliminating the time-consuming process of contacting payers by phone or via the Web.
Features of Misys FastEligibility
- System-wide access to detailed eligibility information that is stored within the patient record and available from any workstation at any time
- Real-time and/or batch transactions for all patients that are scheduled for appointments within the system
- Advanced reporting capability with the status of all batch eligibility requests available via standard Appointment Scheduler reports
- HIPAA compliant with ANSI standard 270/271 eligibility request and response transactions
- Configurable by payer so you can determine which insurance companies to automatically include and exclude in batch transactions. This reduces the amount of money spent on redundant transaction fees while still ensuring the most up-to-date information from the payer (particularly important for Medicaid eligibility where the patient’s eligibility status may change month-to-month).
- Support for a comprehensive list of commercial and governmental payers. Upon initial rollout, Misys will provide connectivity to over 70 commercial, Blue Cross Blue Shields and Medicaid payers – a list that will continue to grow as more payers provide support for this functionality
Frequently Asked Questions
What is Misys FastEligibility?
Misys FastEligibility is an electronic transaction that will allow a user to verify insurance eligibility with a specific payer or group of payers.
What is the benefit of Misys FastEligibility?
Misys FastEligibility is both a risk management and cost savings tool. Humana, one of the nation’s leading insurers, ranks insurance ineligibility as the #1 reason for denial of claims. Without a quick, efficient way to verify eligibility prior to rendering services, providers are placed in the position of debt collector in order to mitigate their financial risk. Additionally, PriceWaterhouseCoopers estimates that it costs the average provider $8, utilizing the traditional methods of manual data entry and phone communications to check-in, verify eligibility for and bill each patient seen. Misys FastEligibility addresses both of these concerns with an easy-to-use, cost-effective method, which minimizes the risk of non-payment and reduces the administrative burden.
How do I get Misys FastEligibility?
Misys FastEligibility is available as a feature of Misys Tiger 3.0.2, which is scheduled to be generally available in December 2004.
How do I use Misys FastEligibility?
Misys FastEligibility is designed for ease of use directly from within Misys Tiger 3.0.2. Misys FastEligibility checks are ordered directly from the Patient Scheduling area of Misys Tiger 3.0.2, and stores the detailed eligibility information directly within each patient’s record.
Does Misys FastEligibility operate in batch or real-time mode?
Misys Fast Eligibility supports both batch and real-time modes. The batch mode offers practices the ultimate in workflow automation and time savings. Each day, simply direct Misys FastEligibility to check eligibility on all patients in a specified time range (typically 24-48 hours in advance). Misys FastEligibility then automatically determines which records to check eligibility on, taking into account payer availability, timeframe of the most recent eligibility check on each patient and specific, user-defined rules. This flexibility provides the optimum mix between ensuring total eligibility verification coverage and minimizing unneeded transactions. The batch mode is designed to provide eligibility verification for the bulk of normally scheduled appointments.
The real-time mode provides fast responses on individual patient requests (typically less than 30 seconds). It is also initiated directly from within the Misys Tiger 3.0.2 application and is intended to provide eligibility verification for walk-in or last- minute appointments.
What type of information does Misys FastEligibility provide?
Misys FastEligibility provides more detailed eligibility information than that provided during the average phone eligibility check. Not only are you provided with a simple yes/no coverage determination varying by payer, you also receive detailed information including, but not limited to, benefit percentages, service type information, specific coverage levels and exclusions. Eligibility status information is viewed in the standard Misys Tiger 3.0.2 Scheduler reports. Additionally, a worklist is provided, highlighting coverages that will require manual intervention in order to verify. This detailed eligibility information can be viewed or printed from any Misys Tiger 3.0.2 workstation within the practice, providing even more workflow efficiencies and flexibility.
Is Misys FastEligibility HIPAA compliant?
Yes. Misys FastEligibility utilizes the latest ANSI standard 270/271 eligibility request and response transaction sets.
What payers are available with Misys FastEligibility?
Upon initial rollout in December 2004, Misys FastEligibility will provide functionality to over 50 commercial, Blue Cross Blue Shield and Medicaid payers. Misys’ connection development roadmap aims at rapidly enlarging this base over time as additional payers support the transaction.
What are the system requirements for Misys FastEligibility?
Misys FastEligibility requires use of the Misys Tiger 3.0.2 application. Batch submission functionality requires the same telephone dial up mechanism used today for basic claims submission while real-time functionality requires an “always on” Internet connection. Misys Sales Consulting can provide specific configuration information and advice.
How is Misys FastEligibility priced?
Currently, Misys FastEligibility is priced at a low, per transaction cost, ensuring that practices gain the full benefit of this value-added service while paying only for each successfully completed transaction.
“Misys FastEligibility is a great asset to our practice. We know in advance when a patient does not have coverage for a particular date of service so we can call them or collect payment the day of service. It also alerts us to issues with their policy number so claims aren't processed incorrectly."
Tawnya Jacoby
Midwest Nephrology Consultants
Kansas City, MO
Call your Misys Inside Sales Executive now to learn more about Misys FastEligibility at (800) 347-3473, Ext. 2867.
