Abstract: Normalizing codified data in an eligibility response and proactively identifying insurance eligibility and benefit documentation issues is provided. Data in an eligibility response may be mapped with other data including data received from healthcare providers, payers, data from inquiries, etc. The data may be stored in tables, and/or in internal and external databases. If there are any determined issues discovered, an alert of the issue found is embedded in the response or the determined issue may be automatically corrected. The alert may provide an instruction on how to rectify the issue to a healthcare provider administrative user. The formatting and structure of the eligibility response may be normalized such that message segments relating to a same service type are grouped together, providing a consistently formatted normalized response. Accordingly, an end user may be able to more easily find information in the normalized eligibility response.

Abstract: Normalizing codified data in an eligibility response and proactively identifying insurance eligibility and benefit documentation issues is provided. Data in an eligibility response may be mapped with other data including data received from healthcare providers, payers, data from inquiries, etc. The data may be stored in tables, and/or in internal and external databases. If there are any determined issues discovered, an alert of the issue found is embedded in the response or the determined issue may be automatically corrected. The alert may provide an instruction on how to rectify the issue to a healthcare provider administrative user. The formatting and structure of the eligibility response may be normalized such that message segments relating to a same service type are grouped together, providing a consistently formatted normalized response. Accordingly, an end user may be able to more easily find information in the normalized eligibility response.