270/271 Realtime Benefits Eligibility

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270/271 Realtime Benefits Eligibility

Reliance on front office staff to manually check for health plan benefit eligibility often results in high customer representative call volumes. Healthcare companies can counter this issue by utilizing real-time eligibility verification. Although there are a limited number of options available, it’s possible to avoid the difficulties of hosted, high priced, and even inaccurate solutions. T-Connect Realtime Benefits Eligibility Services reduce administration for a better employee and patient experience.

Our Approach

At Tallan, we know the value of accurate data in forecasting and enhancing the business decision process. With T-Connect, Realtime Benefits Eligibility brings back ownership from hosted solutions. This means organizations can realize benefits such as reduced costs, improved accuracy, transparent processing, and reduced administration of shuffling enrollment files around. We offer our clients the versatility to deploy our EDI software on premise, in the cloud, or hybrid.

Capabilities

Improve
Accuracy
Data
Transparency
High Performance and Uptime
Plan and
Forecast
Industry
Certified

Improve
Accuracy

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  • Because data is pulled directly from the health plan systems, it’s real-time and more accurate
  • Upfront accuracy to avoid processing errors, eliminate costly re-work, and reduce customer service calls
  • Easy to read and interpret validation errors on 999 rejections

Data
Transparency

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  • Enhance customer service
  • Improve FTE productivity
  • Reduce system maintenance costs
  • Make better business decisions with predictive data analysis
  • Realize a competitive edge

High Performance and Uptime

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  • Industry leading 271 response turnaround time
  • Highly available on-premises and hosted options
  • Microservices technology means the eligibility benefits data can be used across the enterprise including customer service representatives

Plan and
Forecast

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  • Reports, Dashboards, and Portals
  • Data is stored at every stage, every field
  • Out of the box reporting, tracks 270/271 requests and responses
  • Optional portal application allows health plans to white label, and provide easy-to-use search, report, view and eligibility benefit responses – copays, remaining deductible, benefits, and services.
  • View and forecast eligibility request data and correlate to remittances and claim

Industry
Certified

CAQH_Logo Phase 2

Client Story

Third Party Administrator (TPA)

This Third Party Administrator (TPA) is a software design company that provides custom solutions to the insurance industry.

Challenge

This TPA needed an integrated, realtime 270/271 engine to enable plans to query benefit information stored in their eligibility systems.

Solution

T-Connect provided this seamless CORE-compliant functionality with a non-invasive set of services that slid seamlessly into this TPA’s existing infrastructure.

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