Contact Now
Eligibility & Benefits Verification
Eligibility and insurance verification is vital to ensuring accurate and timely receipt of information regarding insurance coverage, and determining the patient’s responsibility to pay for healthcare services. Even then, many healthcare providers do not pay the needed attention to eligibility and verification process. Accurate and timely determination of the patient’s eligibility provides healthcare providers a clear view on patient’s coverage, out-of-network benefits. & accurate insurance information. Incorrect insurance information could result in delayed payments, or denial at worst.
Performing eligibility verification helps healthcare providers submit clean claims. It avoids claim re-submission, reduce demographic or eligibility related rejections and denials, increase collections-leading to improved patient satisfaction. Also, verifying authorization requirement before the service avoids denials, and contributes to increase in collections. Leverage Eligibility Verification & Prior Authorization services to optimize your revenue cycle and improve cash flow.
Why Eligibility & Benefits Verification
- We receive our workflow through the patient scheduling system, Fax, emails, & or FTP files
- We then verify primary and secondary coverage details, including member ID, group ID, Plan effective date, co-pay, deductible and co-insurance information, and specific benefit information if any.
- We use the best way (call or web) to connect with the payer also we assure that every call has its reference number to further probe back if claims goes incorrect by insurance.
- We contact the patient, in case of missing or invalid information (We would require consent from our provider).
- MedFix Value Proposition for Eligibility Verification the most
- Optimize cash flow
- Reduce eligibility related denials
- Help avoiding rejections of claims by Insurance due to inaccurate or incomplete information.
- Improve patient satisfaction
Why Eligibility & Benefits Verification with us
We Help You Overcome the Obstacles to an Optimized Accounts Receivable Cycle. Here's How
Our Process
Our End-to-End Insurance Eligibility Verification Process
Patient Registration
Our insurance eligibility verification process starts from the moment the patient is admitted to obtain medical treatment
Insurance Eligibility Verification
With this step we verify the eligibility criteria of patients and whether the patient has appropriate insurance coverage
Auditing Quality Check
Evaluate for errors and inconsistencies prior to submissions. We contact the insurance companies to obtain approval for authorization request
Collections
Thorough follow up on the patient accounts to
receive the claims reimbursements, appeals,
or any missing information for billing