Institutional Member Liability Estimator (MLE) Tool
The Member Liability Estimator (MLE) tool can provide you with a real-time, estimated member share amount at the time of service, while the patient is still in your facility, prior to claim submission.
This feature enables you to collect copayments, coinsurance and deductible amounts up front, rather than waiting until the claim is processed to reconcile patient accounts.
For additional details, refer to the Institutional MLE Tip Sheet.
The Estimator is not a guarantee of payment. Benefits will be determined once a claim is received and will be based upon, among other things, the member’s eligibility, benefits, limitations and exclusions and the terms of the member’s certificate of coverage in effect on the date services are rendered. Accumulated amounts, such as deductibles, may change as additional claims may have been processed after the estimate was provided.
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