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Real Time Medicare Eligibility Verification
Click HERE for your 5 Free Trials!

Verify your patient's Medicare Eligibility quickly, easily, and inexpensively through our online Medicare Eligibility System. 

A great way to maximize payment and minimize errors on

Batch Eligibility Verification is now available. You can send a batch of requests and receive responses as quick as a few minutes later, depending on the number of requests.  Contact Cortex EDI if interested.

What is Real Time Medicare Eligibility Verification?

Real Time Medicare Eligibility Verification is a fast and secure method to instantly retrieve patient insurance information including:

  • Coverage Information.
    Use Cortex EDI Real Time Medicare Eligibility Verification to get information about services for Medicare patients. You will receive Medicare Part A and Medicare Part B Entitlement/Term Dates

  • Patient Information.
    Retrieve patient information including patient address based on Medicare's records.

  • Primary Insurance Information.
    Find out the primary insurance information if Medicare is the secondary payor.

  • Deductibles.
    Get the Medicare Part A Deductible and Medicare Part B Deductible amounts applied per year.

  • Hospital Data.
    Get Hospital Days Remaining and Hospital Coinsurance Days Remaining.

  • Skilled Nursing Facility Data.
    Retrieve Skilled Nursing Facility Days Remaining and Coinsurance Days Remaining.

  • Home Health and Hospice Data.
    Find out if your patient has had a Home Health Episode, or a Hospice Episode, and the dates of those episodes. Also gives information about the Payer for those episodes.

  • Medicare Part D Data (Pharmacy).
    Receive patient's Pharmacy Plan Name, Contract Number, Plan Number, Phone Number and Enrollment/Dis-enrollment Dates.

  • Medicare Secondary Payer and Medicare HMO Data.
    If patient has Medicare Secondary, or HMO Plan, you will see the Plan Name, Contract Number, Plan Number, Phone Number and Enrollment/Dis-enrollment Dates.

  • Physical, Speech, and Occupational Therapy Data.
    Find out the patient's cap amount for Physical and Speech Therapy, and Occupational Therapy.

  • Updated Medicare Insured ID.
    Receive patient's updated (current) Medicare Insured ID when submitting patient's old Medicare Insured ID. (Some restrictions apply, such as MBI Crosswalk)

  • 24/7.
    Online system available 24 hours a day, 7 days a week.

  • Seconds.
    Automated response returns in just seconds.

  • All States.
    Available in all 50 states in the US, and US Territories.

How much does Real Time Medicare Eligibility cost?

  • 5 Free Trial Requests.
    Get a taste of the site before entering your billing information. There is no obligation.

  • Starting at just $25 per month.

  • Call Cortex EDI for more details at (800) 485-5977 or email

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