Establishing an Embedded Real-Time Eligibility Workflow Within Your System Just Got Easier!

By Denise Junkin posted 09-28-2021 12:15 PM


As a product launch manager, I’m always excited to announce new products and features. Recently, a new Real-Time Eligibility API connection was added for Revenue Performance Advisor!  Both direct providers and partners interested in providing access to Eligibility from within their system will find that the API is an exciting addition to the eligibility connections for Revenue Performance Advisor (RPA).  

Here are the most popular questions I get asked about this new feature:

What is an API?  

An API is an Application Programming Interface.  It’s a technical and standard way for one party to communicate with another.  It gives customers flexibility to access Change Healthcare’s medical network.  An API is not software, a user interface, or a server.  Think of an API like a plug into our system.  

Why did we build this feature?

Today, RPA clients today use SFTP and B2B transactions and portal uploads to send and receive Eligibility Requests and Responses.  We built this feature to offer a new way for our clients to ingest the eligibility information from Change Healthcare to be presented in their system.  It’s exciting to now have the ability to offer our clients a way to display the eligibility responses in their system, in addition to the RPA screens for the workflow and reporting options used today.  

What is JSON?  

JSON stands for JavaScript Object Notation. JSON is a “lightweight” format for transporting and storing data.  JSON is "self-describing", familiar to developers, and easier to understand than the traditional EDI.

What problems are you solving?

For clients wishing to embed the eligibility workflow in their system, the new Eligibility API provides accessible real-time request & response benefits with an easy to code JSON format for users without EDI developers on staff.   We also feel that it’s a best of both worlds approach to Eligibility for RPA clients to implement both real-time and batch transaction workflows in their system. 

My favorite part of this new feature is that the Real-Time API Eligibility connection fits perfectly into the RPA workflows, creating a true online “eligibility filing cabinet” regardless of the eligibility point-of-entry.  It gives our users more flexibility and tools to manage their Eligibility and that helps directly impact the Eligibility based denials our users are working to avoid. 

Are you eager to take advantage of this feature? Is there additional information about this feature you would like? Please give us your feedback by leaving a comment!



11-09-2021 10:36 AM

Hi Mark,
I apologize for the delay in my response.  I spoke with Whitney McKinney, AVP Provider Inside Sales, on your behalf.  She is reaching out to you today to discuss the API Eligibility.  As a side note, you can always email for information on any of our products and services. 
Denise Junkin

10-19-2021 02:22 PM

Hi Denise Junkin,

Can you help us in making API interface between Change Healthcare and our Practice Management software.