Change Healthcare

Member Eligibility Management

Change Healthcare Member Eligibility Management services offer a unique upstream approach for efficient management and utilization of member eligibility data that achieves downstream administrative and medical cost savings. Our suite of member information-driven solutions helps payers strengthen provider self-service, improve member care management, increase auto-adjudication rates, comply with government benefit reporting mandates and facilitate HIPAA and CORE compliance.

Eligibility, authorizations, claim status and other related inquiries are often viewed as just another communication requirement for interaction with providers. Change Healthcare changes that through our ability to take your member information and not only enable real-time transactions through both direct connections and hosted solutions, but also capitalize on our broad solution set to enable efficiencies in downstream healthcare costs by addressing upstream challenges, deploying more solutions with one benefit data set, faster, with minimal risk and greater return on investment.

As always, our nationwide electronic network reach allows us to connect to any system for all payer-to-provider HIPAA-mandated transactions, but the value goes far beyond facilitating traditional pre-care inquiries. By reinventing the approach to member eligibility data management, Change Healthcare enables you to not only serve your provider networks in the best way possible, we are helping improve member health, facilitate regulatory compliance, increase revenue and reduce costs.

Want to better manage your member eligibility data? Let the healthcare efficiency experts review your business and apply our knowledge to your bottom line.

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