Medicare Eligibility Checker
Verify Medicare eligibility and benefits in seconds
Easy Web-based Medicare ID Checker
Medicare Access will never be easier
HIPAA Compliant
Episode Alert's Medicare verification web-based provider portal offers providers with a secure way to verify medicare eligibility and benefits in real-time.
Stop Wasting Time
No longer will you have to make unnecessary calls to Medicare's IVR or DDE's tedious and cumbersome way to check Medicare eligibility for providers.
Live results from CMS
With us, you will get a fast, comprehensive report on your patient's eligibility status straight from the CMS's secure eligibility HETS database (HIPAA Eligibility Transaction System).
How to check Medicare eligibility
Use our simple to use form to verify patient eligibility
1. Click Check patient Button
Before I dive into the meaning of everything you see here, you will need to first check a patient's eligibility. To do that simply click on the check patient button.
2. Enter Patient Info
As you can clearly see we try to make things as simple as possible. Simply enter your patients Medicare number or if your patient has received there new MBI number you can enter that. Either one is fine for the time being. After that go ahead and enter your patient's Name, Date of birth and gender.
3. View your Full Report
With us, you will get a fast, comprehensive report on your patient's eligibility status straight from the CMS's secure eligibility HETS database (HIPAA Eligibility Transaction System).
Medicare Eligibility BatchMode
Check Medicare Eligibility using a spreadsheet
1. Import multiple patients
BatchMode which will allow you to import an excel sheet of multiple patients. Easily check and recheck patients & beneficiaries in one go.
2. Easy to use format
Copy-paste your patient/beneficiary data from an excel sheet or Google sheet and that's it! You can also Export results.
3. One click SNS check
Now you can batch check patient's SNS in one click. We will only check the SNS for patients who are Part B active, no active HMO, PPO and have no active hospice episodes.
Medicare Eligibility Verification
Quickly and easily verify patients Medicare coverage.
Part A & B, CMS Note, Patient Address
Get all your patient basic information here
Part A & B Coverage
Corrections, Part A and B Eligibility. Columns include Patient Name, MBI, DOB, Sex, Part A Eligibility Start, Part A End, Part B Eligibility Start, Part B End, DOD
CMS Note
CMS insured notes like OASIS, ESRD, disability,Railroad Retirement. Columns include Note Details (ex: Beneficiary insured due to age OASIS)
Beneficiary Address
Shows the beneficiary's address per CMS
Inpatient, SNF, Hospital Stays, Part B Deductible
Find the important start dates and deductibles with ease
Inpatient Deductible
Part A Deductible, Inpatient, SNF, Lifetime. Columns include Start Date, End Date, Part A Deductible Left Inpatient Full Days Left, Inpatient Copay Days Left, Inpatient Copay Amount, SNF Full Days Left, SNF Copayment Days Left, SNF Copay Amount, Lifetime Reserve Days Left, Lifetime Daily Copayment Amount
SNF / Hospital Stays
Specific dates of individual Hospital/SNF stays within the complete spell. Visit Type, Stay Start Date, End Date, Billing, NPI, DOEBA, DOLBA
Part B Deductible / Caps
Part B. Columns include Part B Year, Part B Deductible Left, Co-Insurance Amount
QMB status, Home Health, MSP
Easy to read report for all providers
QMB Status
QMB enrollees are dually-eligible for Medicare & Medicaid. Not liable for Medicare co-insurance,co-payments,deductible payments. Columns include State, QMB Plan Start, Date End Date
Home Health
Late Episode - Home Health / PPS Episode Periods. Columns include Start Date, End Date, NPI#, Provider Name, Provider Address, City, State, Zip, Phone#, DOEBA, DOLBA, Patient Status
MSP
Medicare secondary payer or sometimes known as a private health insurer. This section will give you the MSP type, policy number, insurer name, address, and start and end date
Plan coverage, Part D, Hospice
Never second guess a patient's information again with our easy-to-read report
Plan Coverage, HMO, PPO
This section will give you all the patient's HMO, PPO, includes Plan Type, Contract#,
Contract Name, Plan Name, Phone #, Address, Address2, OPT, Start Date, End Date, URL
Part D
You will find all your patient's Part D plan information here like plan ID, contact information, includes Plan Id, Part D Name, Phone #, Part D Address 1, Address 2, Start Date, End Date, URL
Hospice
This section covers hospice periods for your patient, including Start Date, End Date, Days Used, NPI#, Hospice Name, Address City, State, Zip, Phone#, Revocation Code, Hospice Coverage
Preventative Services
Now know exactly when the eligible date for screening, test, annual wellness visits, and more
Wellness visits & Diabetes-related services
Annual Wellness Visit, Diabetes screening includes HCPCS/Modifier, Next Eligible Date, Description, Category
Tests & Screenings and Counseling & Therapy
Alcohol misuse screening and counseling, Intensive behavioral therapy for obesity, Medical nutrition therapy, Alcohol misuse screening and counseling, Intensive behavioral therapy for obesity, Medical nutrition therapy
Mental Health Services & more
Depression screening, Bone Mass Measurements, Cervical Cancer Screening, Colorectal Cancer Screening Tests, Pneumococcal Shot & Administration, Prostate Cancer Screening, STI Screening & HIBC to Prevent STIs, Ultrasound AAA Screening
Therapy services, COVID Vaccination, Flu Vaccination
See all your patients / beneficiary health data in-one-place
Therapy services
Get the amount used for both Physical & Speech Therapy and Occupational Therapy includes Therapy Type, Amount Used, Start Date, End Date
COVID-19 Vaccination
Returns the most recent information for COVID-19 vaccination including rendering NPI includes CPT or HCPCS, Date of Service, Short Descriptor, Vaccine/Procedure Name, NPI, Provider Name, Provider Address, Provider Address2, Provider, Phone#
Influenza (Flu) Vaccination
Returns the most recent information for Influenza (Flu) Vaccination including rendering NPI includes CPT or HCPCS, Date of Service, Short Descriptor, Vaccine/Procedure Name, NPI#, Provider Name, Provider Address, Provider Address2, Provider, Phone#
Any questions? Check out the FAQ
Let us answer any questions you may have
Yes, we receive all information directly from the CMS HETS system in real-time.
Yes, BatchMode is available with all plans that include Medicare Eligibility.
Yes, we cover all preventative services such as lab tests, flu shots, health screenings, COVID vaccines, therapy services, and more.
Our starter plan for eligibity will be $38 per month and give you access to 100 checks per month. We do allow all customers to upgrade and downgrade anytime to fit their needs.
No, you can have as many users as needed to run eligibility checks.
Why choose Episode Alert’s Medicare eligibility checker?
Some of the reasons we are the best choice
Real-time fast benefit information results straight from CMS (Centers for Medicare & Medicaid Services)
One-click downloadable full PDF reports of patient Eligibility Verification
Easily identify Primary payer’s and the Medicare secondary payer
Spell Information for Home Health and Skilled Nursing Facilities
Hospice Episode information and dates
Run large Batches of patients easily and quickly with Eligibility BatchMode
Streamline enrollment for your patients with our seamless medicare eligibility checking service
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Medicare Eligibility sample report
Verify Medicare eligibility and benefits in seconds
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