Eligibility & Verification Benefits

Effortless Eligibility and Benefit Verification Process

Patient eligibility refers to a process that determines if someone can receive medical care within a specific health plan. This involves checking whether such details as the patient’s demography, coverage of his/her insurance, and any other useful data that can indicate his/her qualification for medical services. Evaluating patient eligibility properly helps to make billing less complicated hence preventing denial of claims.

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Eligibility & Verification Service

Customized Eligibility Services

Group of specialists aim to expedite client’s accounts receivable cycle and optimize revenue management.

Confirmation of Insurance and Benefits

Apart from the obvious, we properly confirm insurance and benefits with the patient's first and second payers. This includes verifying if the patient had active coverage on the date of service as well as understanding intricacies of benefit options like copays, coinsurance, and deductibles.


Prior Authorization Trigger

Whenever a request for prior authorizations is necessary, our experienced team leads in initiating these processes as well as securing approvals needed for an intended treatment. This way, delays are avoided while ensuring that the patient has a good experience.


Revenue Cycle System Updates in Detail

Following the verification procedures, such details are promptly recorded into the revenue cycle system of the hospital or the practice management system where this data comes from. It helps to improve accuracy in financial transactions by using real-time data integration which makes it possible to view how much money is being spent on what.


Reduce Bad Debts

Our early determination of patient responsibility for payments leads to less bad debt and more cash collection, resulting in a more positive financial outlook. This proactive approach reduces patient debt and increases point-of-service (POS) collections. The result is not only better cash collection, but also increased patient satisfaction due to clear financial transactions.