Enrollment and Eligibility Management

MED3OOO manages all aspects of enrollment and eligibility for our IPA clients.  On a monthly basis, eligibility files are received from each contracted health plan and loaded into our managed care information system.  Full-file reconciliation is performed each month for each health plan to ensure your patients are loaded appropriately.  MED3OOO maintains and updates eligibility databases monthly to track your patients’ co-payments, co-insurance, deductibles, coverage limitations, lifetime maximum benefits, and other benefits as provided by each contracted health plan.  As a value-added feature, your providers have the advantage of verifying their patients’ eligibility prior to providing medical services by logging onto a secure internet portal.  This portal allows providers to check eligibility, benefits, and status of authorizations and claims.