Medicare Eligibility Verification

Verify your referral - patient in seconds


Episode Alert's Medicare verification web-based system offers providers with secure real-time patient eligibility and benefits. No longer will you have to make unnecessary calls to Medicare's IVR or DDE's tedious and cumbersome way of checking your patients Medicare eligibility.

With us, you will get a fast, comprehensive report on your patient's eligibility status straight from the Medicare’s secure eligibility HETS database (HIPAA Eligibility Transaction System).


Get real-time report

Medicare Access, deductibles & more

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


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    Easy to use

    No training needed and no software to download.

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    Be Up & Running

    Have access quickly after signing up, be working fast.

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    Fast Connection

    Quick web-based access to Medicare - No dial up.

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    Very Affordable

    Fixed cost, budget friendly plans. No risk free trial.

How easy is it to verify a patients Medicare Eligibility

So you're wondering how you can check your patient's Medicare eligible. Well, your in luck because Episode Alert is the perfect place for you to find out. With us. you will be able to verify your patient and also find out all the must-know information that comes along with it. So let me take you on a step by step guide to Medicare verification with Episode Alert

Once your signing into episode alert you will have a view of our Medicare verification page

episode alerts medicare elegibility page

What you are seeing in this image is our Summary log of all your patients that you have checked. But before I dive into the meaning of everything you see here, you will need to first check a patient's Medicare elegibility. To do that simply click on the check patient button and you will be greeted with the following screen :

episode alerts medicare check patient screen

As you can clearly see we try to make things as simple as possible for our clients. Simply enter in 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.

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.

episode alerts medicare elegibility page

Let's explain some of what you are seeing here. At the top, you have a few options. Check a patient which we have just covered, Batch mode which will allow you to import an excel sheet of multiple patients. Next to that is our help section followed by the Mac helplines and last is where you can find some useful video showing you all of our services.

Now let's talk about the summary log of your Medicare patients. Starting from the left with have a 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.

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 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.

Now let's see what a report looks like:

the CWF report from medicare
the CWF report from medicare

As you can clearly see on this Medicare 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. Remember we are always here to answer any questions you have. Just give us call at 1-866-905-0698

 
 

Service Specific FAQ's

Yes, available with all plans that include Medicare Eligibility. Easy as 1,2,3.

Yes, Episode Alert has been ready for the transition for years. Since early 2007, Episode Alert has been involved with CMS in developing HETS 270/271. Utilizing Episode Alert eligibility verification ensures your organization will automatically be ready for the transition with no interruption in operations.

Please feel free to submit a support request and we’ll be happy to respond if you ever have any questions about any of the Episode Alert™ solutions or even about the sign up process itself.