Real-time claims estimators (RTCE) can be used to show the allowable for a service or set of services, along with the patient’s cost share for those services. RTCEs take into account the specific patient’s plan, any accrued deductible or out-of-pocket expense, the in- or out-of-network status of the provider, and the cost of specific proposed services.
Real-time claims estimators: Cigna
- CignaForHCP > Patients
- Enter patient information.
- Click Estimate Costs.
Real-time claims estimators: Aetna, Cigna, Humana, local BCBS plans (BCBS AR, FL, IL, KS, MS, NM, OK, SC, TN, TX and Highmark):
- Availity > Patient Registration > Eligibility & Benefits Inquiry
- Select payer from the dropdown.
- Enter patient information.
- Click Patient Care Estimator.
Real-time claims estimators: United plans:
- UHCProvider > Link > United Healthcare Claim Estimator
- Click Pre-Determination of Benefits > Agree
- Confirm provider information > Continue
- Enter patient information.