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:
Optum Intelligent EDI (formerly Ingenix/ENS): 2525 Lake Park Blvd., Salt Lake City, UT 84120
NOTE: If your office is sending direct to some carriers, you may NOT do Eligibility through Optum Intelligent EDI for those carriers.
For support:
Contact PCS Training:
• 626-449-1705, option 7
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, Channel Partner Executive
Email: Debra.Campos@Cognizant.com
Phone: (619) 597-9024
• Customer Service: 1-800-556-2231
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.
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
Data Dimensions: 400 Midland Ct., Janesville, WI 53546
Data Dimensions is a technology services company that provides integrated solutions for the P&C industry with our EDI CLEARINGHOUSE, DIGITAL MAILROOM & PAYMENTS services. datadimensions.com/
• Contact: (608) 373-6255 or 1 (888) 996-9903
Change Healthcare (formerly Emdeon/Capario)
Effective Fall 2022, Change Healthcare, Healthcare Partners, and Davits are under Optum Intelligent EDI.
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
Inovalon/Ability ABILITY EASE All-Payer, ACCESS RCM, or CHOICE All-Payer
100 North 6th St., Suite 900A, Minneapolis, MN 55403
• Contact: Courtney Osteen, Principle Business Development Manager
1-612-277-3939, Courtney.Osteen@inovalon.com
Ability Network (Direct Medicare)
Contact: Prime Clinical Systems Inc. support@Primeclinical.com
626-449-1705
Refer to Eligibility Verification Feature Overview for more information on Eligibility Verification.