Eligibility and Benefits Verification Services
We understand the challenges healthcare providers face in handling insurance eligibility verification processes. With a focus on reducing denials, our complete range of insurance eligibility and benefits verification services can seamlessly integrate with your existing systems.
Details of Our Eligibility and Benefits Verification Process
We follow a well-defined set of steps to ensure that all necessary information is collected, verified, and documented accurately. Following are the steps involved in our eligibility and benefits verification process:
- Patient Information Gathering: The first step is to collect the patient’s demographic information and insurance details. This includes the patient’s name, date of birth, insurance carrier, policy number, and group number.
- Eligibility Verification: Once the patient’s insurance information is collected, we contact their insurance company to verify their eligibility. This involves confirming that the patient is actively enrolled in the plan and that the services they are scheduled for are covered.
- Benefits Verification: We also verify the patient’s benefits to understand their co-pays, deductibles, and out-of-pocket maximums. This information is essential for providing accurate patient estimates and avoiding overbilling.
- Pre-Authorization / Pre-Certification: For certain services, such as surgery or hospitalization, the patient’s insurance company may require pre-authorization or pre-certification. We will handle this process on your behalf to ensure that the necessary approvals are obtained before the services are rendered.
- Documentation: We accurately document the entire benefits verification process, including the dates and times of contact, the names of the insurance representatives spoken to, and all relevant information obtained. This documentation serves as a valuable reference for future inquiries or audits.
Benefits of Our Eligibility and Benefits Verification Services
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Improved Accuracy
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Reduced Denials
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Increased Revenue
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HIPAA Compliance
To learn more about our eligibility and benefits verification services, please call us, or fill out the inquiry form and see how we can help. We would be happy to answer any of your questions and provide you with a free quote.