Medicare Eligibility Checker

Why choose Episode Alert’s Medicare eligibility checker?

• Real-time fast results straight from CMS
• Easily identify Primary payer’s if Medicare is the secondary payer
• One-click downloadable full PDF reports of patient Eligibility Verification
• Spell Information for Home Health and Skilled Nursing Facilities
• Hospice Episode information and dates
• Run large Batches of patients easily and quickly with Eligibility batch mode

Easy Web-based Medicare verifications

Medicare Access will never be easier

Episode Alert's Medicare verification web-based system offers providers with a secure way to verify medicare eligibility and benefits in real-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.

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).

Get real-time reports

Straight from the CWF and HETS database

Our Medicare eligibility verification reports are real-time coming straight from the HETS database and CWF. Simply open your report and be amazed at how simple our verification reports are easy to read.

In these reports, you can easily see: your patient's general information. Including there HIC number, DOB, Sex, Address. Sections for Part A/B benefits and deductibles, home health benefits periods, PPS, MSP, and Hospice episode periods and HMO plan Information.

Easy to use No training needed and no software to download. Easily check Medicare eligibility for providers.

Be Up & Running Have access quickly after signing up, be working fast.

Fast Connection Quick web-based access to CMS - No dial-up.

Very Affordable Fixed cost, budget-friendly plans. No risk-free trial.

How to check Medicare eligibility

Use our simple to use form to verify patient eligibility

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 and you will be greeted with the following screen :

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.

HETS vs. CWF

We provide eligibility reports from both CMS sources

Now you may be wondering what is the difference in the CMS system drop-down option so let me give you a little explanation on both. The CWF stands for Common Working File and comes from the DDE/FISS system. It is generally used by home health agencies and Hospices. HETS stands for HIPPA Eligibility Transaction System and is more suitable for DME's. However, we recommend you try both and see what works best for you.

Ok, so after entering all your patient's information you will be brought back to the Summary log.

Medicare Eligibility BatchMode

Check Medicare Eligibility using a spreadsheet

Batch mode which will allow you to import an excel sheet of multiple patients. Easily check and recheck patients & beneficiaries in one go. Copy-paste your patient/beneficiary data from an excel sheet or Google sheet and that's it! You can also Export results.

Summary Log Quick Tools

Easily Re-Check & access Detailed Reports

Now let's talk about the summary log of your Medicare patients. Starting from the left with we have our paper Icon which will show you a detailed report on each patient (we will go over that in a few moments) next is the CFW screens inside the DDE system followed by a handy little button to recheck your patients.

Summary Log Quick Check

Quickly check if beneficiary/patient is Medicare eligible

The next columns in the summary log are the Date checked the Patient name, Medicare number, DOB and gender are all self-explanatory. After that, you will be shown if the patient is active (A) or inactive (I) with part A, part B, PPS, MSP, HMO, and Hospice. Along with part B deductible, DOD, report type (CWF or HETS) and a green check if the patient has been found or a red X if not.

Detailed Report

Now let's see what a report looks like

As you can clearly see on this eligibility report all the information you could ever possibly need is right here at your fingertips. Especially, those pesky overlapping overages that can sneak up on home health agencies. So make sure to double-check that PPS section.

OK, so I hope you found some great information and now you will have no trouble when you need to verify Medicare coverage of your patients. Remember we are always here to answer any questions you have. Just give us a call at 1-866-905-0698 or Ask us a question

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