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Eligibility Updates

Based on your feedback, we’re excited to announce a new way to do eligibility estimates at Healthy Bytes!

Our goal is to make sure you have key patient information at your fingertips and that you get your claims paid as quickly and reliably as possible. We have found that for most claims, the “traditional” eligibility estimate is not the most effective way to accomplish this goal.

Below, you’ll see answers to some of the questions we’ve already been asked about this change. You’ll also have the chance to ask your own questions.


What’s the new way of conducting eligibility estimates?

Now, you’ll see real-time insurance information displayed right on your dashboard- for most insurance companies, check any time day or night to see if a patient has active coverage, see plan types, copay information, even (with certain insurance companies and plans) real-time deductible accumulations! 

This real-time (!) information can replace eligibility estimates and is all you’ll need to successfully file and get your claims paid. It is particularly good for when you see a lot of folks with the same plan but you need to double check that a given patient still has valid benefits or that they haven’t changed insurance. From July 15th, you’ll be able to do that any time, in real-time, for free. 

You’ll also have access to Healthy Bytes average claim info for how this has paid for you and other providers in the past—coming late 2019. 

Special Case Eligibility Estimates

Have a patient with an insurance company you haven’t dealt with in a long time and don’t remember your contract details? Need to see if you can get something special covered, like out-of-network benefits or a patient from out-of-state? Need help with a pre-authorization? No problem! 

You can request a Special Case Estimate for $4.99 with a 5 business day turnaround. Need someone to drop everything and get it done now? It will be $9.99 for a Rush Estimate if you submit the request before 1pm ET on business days.

What if a claim is denied? 

We will fight for that claim. As long as a patient has active coverage, we’ve found that eligibility estimates are less effective than past reimbursements across providers for getting the vast majority of claims paid. Especially when we use our nationwide database of what should be paid by a given insurance company and plan. We will put all of our energy into getting you paid and making it as seamless as possible for your patients. 

What if a claim is denied correctly and the patient needs to pay? 

Starting the Week of July 15th, 2019. We will provide you with free practice docs that you can give to your patients. We have found these work well to establish a good rapport upfront and take the surprise out of insurance billing with or without an eligibility estimate: 

  1. Explanations of benefits (EOBs) are not a bill

  2. Patient financial responsibility agreements 


Additional questions?

We’ll reply to you via email and also include questions we receive often above.
They’ll be anonymized, of course.

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