Eligibility Verification

Eligibility Verification

Eligibility and insurance verification are vital to ensuring accurate and timely receipt of information regarding insurance coverage. Without proper checks and balances in place, a healthcare organization could be leaving money on the table. Physicians need to verify each patient’s eligibility and benefits to ensure they will receive payment for services rendered. Patient’s demographic data, insurance coverage, benefit option and authorization details are the prerequisite eligibility verification prior to patient’s office visit. Our team of specialists completes all the following benefit verification work well before the office visit and follow up with payers after the initial submission till confirmation is obtained.

  • Payable benefits
  • Co-pays
  • Co-insurances
  • Deductibles
  • Patient policy status
  • Effective date
  • Type of plan and coverage details
  • Plan exclusions
  • Claims mailing address
  • Referrals & pre-authorizations
  • Health insurance caps
  • DME reimbursement

It prevents denial, avoiding delay in payment boost revenue at time of service, save time on the back end, and also enhances patient satisfaction.