http://www.hospitalmanagementsoftware.com/Community/Forums/tabid/181/forumid/69/scope/threads/Default.aspx2010-09-05T11:04:25Z2009-05-11T03:41:56Z302009-05-11T03:41:56ZDPhttp://www.hospitalmanagementsoftware.com/Community/Forums/tabid/181/forumid/69/threadid/37/scope/posts/Default.aspx<p><strong>Hospital Management Software - Eligibility</strong></p> <p>When a patient is treated in a private hospital, most of the time the bill is paid by the insurer.</p> <p>The hospital needs to confirm that the insurer named by the patient actually has insured the patient. Insurer also needs to confirm that the patient is covered for the condition for which the patient is being treated.</p> <p>Hospital also needs to know about the gap between the hospital bill and the payment to be received from insurer so that the gap money can be charged to the patient.</p> <p>The communication between the hospital and the insurer can be through phone, fax or through the web service provided by the insurer. The software should be able to call the appropriate web service based on the insurer with the parameters required by the web service. The response received from the insurer web service has to be stored in the database.</p> <p>Does your hospital conduct eligibility checks?</p>