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  • Are your patient eligibility services and software HIPAA compliant?
    Yes. Our services and software protect patient privacy and adhere to all HIPAA regulations as well as site-specific procedures and compliance standards.
  • Can you ensure our patients will be served with dignity and respect?
    Yes. Our on-site staff work as advocates for your patients and are committed to supporting them with empathy and empowering them with education. Our one-on-one, face-to-face interactions with your patients greatly increase patient loyalty to your organization and improve patient engagement.
  • How can your patient eligibility solutions help our patients?
    Our top goal at EligibilityOne is to help you support your patients through patient advocacy. Our patient eligibility service reduces or eliminates patients’ out-of-pocket costs, identifies financial assistance opportunities and manages the application process for patients, provides patient financial counseling and education, and alleviates patients’ financial confusion and stress. We also offer ED staffing and expanded hours compared to most eligibility and enrollment services (we have on-site eligibility advocates available at a minimum of 12 hours/day, 6 days/week), helping to ensure your patients find support when they need it.
  • How can your patient eligibility solutions improve our revenue cycle?
    EligibilityOne reduces uncompensated care and write offs by exhausting all possible funding sources for patient accounts. We verify insurance benefits in real-time and find unreported insurance coverage, screen for financial assistance, charity, and public benefits eligibility, and manage out-of-state Medicaid claims. And because our on-site patient eligibility service operates face-to-face and at a minimum of 12 hours/day and 6 days/week, we see higher conversion rates, increased point-of-service payments, and overall improved patient collections. With EligibilityOne, your facility or health system will always be the “payer of last resort.” Additionally, our pre-arrival workflow solution streamlines financial clearance and prevents errors that lead to denials, reimbursement delays, or rework.
  • Will we have to replace our current EMR/EHR system or other technology?
    No; there is no need to lose your investment in your current technology. Our software can integrate with all the major EHR/EMR platforms and work seamlessly with HL7, FHIR, DirectQuery, data feeds, and custom APIs.
  • How do you price your patient eligibility services?
    We offer contingent fee pricing – you only pay for our services when you get paid!
  • Can you bill out-of-state Medicaid?
    Absolutely, there are specific guidelines that must be met, but we take care of everything from getting the physician and hospital enrolled to billing and following up on the claim until payment is secured or denial. If a denial can be or should be reconsidered, we handle the appeals process up to final denial.
  • Is the provider enrollment process efficient, and are applications being handled in a timely manner?
    This is dependent upon the provider and our company working together to be successful. We do need documents and signatures from the provider and/or facility and are reliant on receiving these documents back in their entirety to proceed. Personal and sensitive information (home address, social security number, drivers license, place of birth, etc.,) is needed from physician and board members, which often is difficult to obtain, especially when working within a paper application. Given that the requirements vary from state to state, there is no master resource and each state varies dramatically.
  • Can we email referral's directly to your team?
    Yes, can send referrals via email directly to your point of contact.
  • How long will an enrollment usually take once you receive the referral?
    This can vary depending on the State . This can take anywhere from 30 days to 6 months.
  • Will you enroll with the Medicaid HMO's?
    Yes, if we receive a referral in which an enrollment with the HMO is required.
  • How will you obtain the necessary information required to complete the enrollments?
    We will request facility documentation upon initiation of contract and will request Physician information only if an enrollment is required.
  • Why should we partner with EligibilityOne?
    EligibilityOne is the new standard in patient eligibility. Our higher performance standards entail: Extensive coverage of at least 12 hours a day and 6 days a week Emergency Department staffing Mobile screening software for bedside eligibility screening and in-field advocacy Forms automation Face-to-face interactions with patients Automated patient outreach messaging ALL accounts are worked across EVERY area (e.g. IP, OP, ED) All unlinked accounts are closed within 30 days In merging cutting-edge technology with the personal touch of our expert, on-site patient advocates, EligibilityAdvocates delivers the perfect balance of automation and human interaction needed to maximize your patient advocacy efforts and improve your revenue cycle.
  • Is EligibilityOne's technology secure?
    Yes! We take security and personal data seriously. Below is a list of how we keep your data protected. AWS Environment: The entire EA environment is hosted within AWS There are multiple subnets to separate PROD, STAGE, and DEV environments Route tables are configured to restrict traffic between subnets Security Groups are configured to restrict IP and Port traffic between servers Managed prefix lists are used to whitelist IP traffic All volumes encrypted with AWS key pairs (AES-256) ESET Server Security deployed on all servers SonicWall NSv270 The entire EA environment is fronted with a SonicWall NSv270 firewall to manage all inbound and outbound traffic. Services enabled are Intrusion Prevention, Advanced Threat Protection, Anti-malware, Content Filtering, and Geo-IP Filtering. Backups Nightly, weekly, and monthly snapshots performed on all critical servers Monthly snapshots on non-critical servers Daily snapshots retained for six months; weekly snapshots retained for one year; monthly snapshots retained for two years Environment Security Deprecated protocols and ciphers are disabled Protocols used are HTTPS, TLS 1.2, and SFTP Encryption methods include AES-256 and RSA 2048 Annual third-party penetration and vulnerability scans Quarterly SSL security tests through Qualys/SSL Labs Windows security updates applied monthly Application Accessed via Citrix (DaaS Advanced Plus) Citrix MFA enabled and enforced Users authenticate first through Citrix MFA and then through the application The application uses a combination of workstation name and user id/password to authenticate Endpoints All remote devices are encrypted ESET Endpoint Security deployed on all remote devices Users Complex password policy enforced and enabled Principle of Least Privilege (POLP) followed MFA enabled and enforced for Office365 and Citrix Information Security Third-party security partner for policy assurance and risk analysis In final stages of updating all our existing policies; anticipated completion end of month Just hired a CISO to primarily focus on SOC certification by 2nd Quarter 2023 Staff are required to read all policies and sign an acknowledgement form Background checks performed as part of the pre-screening process for all staff Exit interviews and checklists completed as part of any termination Utilize KnowBe4 to manage HIPAA and Security compliance Utilize KnowBe4 to execute email phishing campaigns Utilize KnowBe4 to manage phish alerts Utilize a product called Teramind that interrogates user activity for signs of non-compliance 10MM Cyber Liability Insurance
  • Can you help with prior authorizations?
    Yes, Our system automatically initiates authorization requests and provides continuous monitoring for status updates. Seamlessly update all relevant information directly on the patient's electronic medical record (EMR)/electronic health record (EHR) platform. Our seasoned onshore team is dedicated to reviewing any denials and proactively resubmitting for authorization approval.
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