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.