Eligibility

Trust your member data again.

Empower Health Eligibility unlocks trapped revenue and eliminates unnecessary claims payments by enabling confidence in your membership eligibility.

Struggling with unreliable transactions?

If you provide health insurance, you need accurate eligibility transactions. But problems arise – member data can be invalid, out-of-date, or even fail to transmit, leading to poor customer service, unbilled premiums or payment of ineligible claims.

Control your data.

Empower Health Eligibility is the first solution to give you a true single-window view into all your members and protect your systems from bad eligibility data. Incoming transaction files are quickly validated, archived, and transformed. Empower Health immediately identifies bad data then corrects the problem or generates an alert so that a human can analyze.

Stop reacting and be proactive.

Your team can access each member’s demographic and transactional history in a modern, easy-to-use dashboard. Update member data and control what gets sent downstream.

It’s time to stop wasting valuable time searching for the root cause of problems and painstakingly using limited options to correct them.

Empower Health speeds your processes, ensures billing for all premiums, eliminates invalid claim payment and keeps your customers happy.

Covert
Covert

Full management console or just back-end services.

Data Interchange

  • Online portal for carrier users
  • Receive & validate
  • Provide CMS & State-based HIX Integration
  • Convert to member data
  • Work queue & tools for errors
  • Generate & transmit transaction files (CMS and carrier)
  • Log & archive

File-based Enrollment

  • Receive & validate
  • Provide CMS & State-based HIX Integration
  • Ideal for your large groups that are invested in an HR system and just need to get you the open enrollments, new hires, adds and terms in an efficient manner.