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E-Eligibility: A Practice Essential

By: Nextech | July 15th, 2013

E-Eligibility: A Practice Essential Blog Feature

It is a routine the front desk staff of a doctor’s office experiences tens, maybe hundreds, of times a day. A patient walks through the door, goes up to the front desk and proceeds to go about checking in for their appointment. There was once a time when most patients carried reliable healthcare plans and checking in for an appointment with their physician was simple. Today, with shaky economic times and a continuously evolving healthcare system, making sure that patients have the necessary health coverage to cover the cost of their office visit is harder than ever.

According to a study published by the Medical Group Management Association (MGMA), the single, most important piece of technology a doctor’s office can have is an electronic eligibility verification tool. With an increase of more than 35% of patients being underinsured today, NexTech and Gateway EDI partnered to bring joint clients the ability to check the eligibility status of patients before they walk through the door. NexTech’s Practice Management and Electronic Medical Record solution integrates with Gateway EDI to verify eligibility through their nationwide network of thousands of payers in just seconds.

E-Eligibility - Nextech

Have you ever taken a moment to measure how much time is spent verifying eligibility at your practice? On average, an office assistant can spend up to 7 minutes verifying the status of each patient’s eligibility at a cost of $3.70 per claim. By adopting E-Eligibility technology the American Medical Association (AMA) concludes a practice could see a nearly $4,000 cost savings per physician! This reduces the dollar figure of verifying eligibility to a mere $0.74. It’s safe to say … the payoff of E-Eligibility is astounding! Through an integrated eligibility solution, NexTech and Gateway EDI clients can dramatically reduce labor costs and streamline the payment process, eliminating the backend arduous task of calling, waiting on hold, reciting the patient’s information and then relaying that information on to the patient. Far too often, offices allow patients to proceed with their appointments without verifying benefits in time, thus leading to claim rejections or reduced reimbursements. 

If you do the math, it’s clear. By not incorporating E-Eligibility into the daily routine, offices lose money by adding to their pile of denied claims. With the combined power of NexTech and Gateway EDI E-Eligibility solution will save time, increase efficiency and drive revenue.

Visit or contact Mark Bentley at 1 (800) 969-366, Ext. 1659, for more information.