Intellect™
THIRD-PARTY VENDOR OPTIONS
Eligibility Verification
Effective version 9.12.01
The third-party vendors currently working with Prime Clinical Systems in regard to Eligibility Verification are:
OptumInsight (formerly Ingenix/ENS): 2525 Lake Park Blvd., Salt Lake City, UT 84120
(If your office is sending direct to some carriers, you may NOT do Eligibility through OptumInsight for those carriers)
• Real Time Eligibility submission available
• Contact: Rebecca Barnes at 801-982-3033
• Fax: 888-869-5199
• email: Rebecca.barnes@optum.com
• web: www.optum.com/
• Sales:
• James Zurawski
Email: james_zurawski@optum.com
Phone: 678-231-7818
• Support:
• Carolyn Mast
1755 Telstar Drive, Ste 400
Colorado Springs, CO 80920
Email: carolyn.mast@optum.com
Phone: 1-866-367-9778
Online Client Help Documentation:
OPTUM Web Portal Support Access
OPTUM Web Portal Access Information
Cognizant (formerly TriZetto/Gateway) EDI: 501 N. Broadway, Third Floor, St. Louis, MO 63102
Cognizant is an American multinational corporation that provides IT services, including digital, technology, consulting, and operations services.
• Real Time Eligibility and Batch Mode submission available.
• Phone: (800) 969-3666
• http://www.trizettoprovider.com
• Eligibility Verification: Available on Windows Platform only
• Payer list: http://www.trizettoprovider.com/Resources/Payer-List
• Sales:
• Debra V. Campos, Enterprise Account Manager/Sales Overlay Exec
Email: Debra.Campos@Cognizant.com
Phone: (619) 597-9024
• Support:
• April White, Channel Partner Account Manager
Email: April. White@Cognizant.com
Phone: (800) 969-3666 ext. 3738
Established clients may call customer Service at (800) 969-3666, or, if the matter needs to be expedited or needs a quick answer, contact your Vendor Account Manager.
Cognizant interfaces with OnSTAFF Intellect for these features:
• Electronic Billing via SFTP: Easy claim submission without having to leave the software for primary and secondary claims.
• Electronic Remittance Advice: Autoposting of remit files allows an efficient, effortless payment posting process.
• Eligibility Verification: Allows for easy benefit inquires within the software or can processed in batches with multiple patients at one time.
• Electronic Patient Stations: Upload patient statement files through an automated printing and mailing system, eliminating the need to do the work done in office.
Cognizant also offers Denials Workflow Solution, Advanced Coding Edits, and Credentialing Services.
Waystar (formerly ZirMed): 888 W Market Street, Ste 400, Louisville, KY 40202
• Real Time Eligibility submission available
• Phone: 1-877-494-7633, option 1
• https://www.zirmed.com
• Eligibility Verification: Available on Windows Platform only
• Sales:
Robbie Abt - National VP Channel Sales
770-342-0278
• Support:
Waystar/ZirMed Client Support
877-494-7633
There are four team leads in Technical Support. If you need escalations on anything, just call 877-494-7633, select option 1, and ask for a Team Lead. Their names are Gio Santiago, Jennifer Disney, Taylor Steff, and Laurel Anderson.
• Support Escalation:
Laurel Anderson - Client Support Team Lead
877-494-7633
502-238-9239
• Partner Integration:
Steve Otey - Partner Integration Manager
877-494-7633 x4327
Work Comp EDI: New York Data Center, 4250 Veterans Memorial Hwy Suite 301E, Holbrook, NY 11741
• Work Comp EDI does not support either Real Time Eligibility or Batch Mode submission at this time. However, Intellect has the ability to add special Worker's Comp legal forms using standard X125010, 837 format. Data is required to be the same as that used for Worker's Comp.
• Phone: (800) 297-6909 ext. 1318, Fax: 631-648-6023
• http://www.WorkCompEDI.com
• Eligibility Verification: Available on Windows Platform only
• Contact: Jennifer Jones; Email: JJones@WorkCompEDI.com
Change Healthcare (formerly Emdeon/Capario)
Note: Change Healthcare is not a contracted vendor.
• Real Time Eligibility and Batch Mode submission available.
Note: Users needs to check with Change Healthcare if they need to choose one method over another. Prime Clinical suggests that users choose one method and always use that one.
• Contact: 1 (800) 792-5256
• web: www.changehealthcare.com
Refer to Eligibility Verification Feature Overview for more information on Eligibility Verification.