Eligibility And Benefits Verification
Ensure Claims Accuracy with Our
Advanced Eligibility In Medical Billing Verification Services
Ensure Claims Accuracy with Our Advanced Eligibility Verification Services
Our Goal is Clean Claim Submission
Ineffectual eligibility and benefits verification, coupled with deficient prior authorization procedures, contribute to the recurrent incidence of delayed payments and claim rejections, consequently diminishing overall collections and revenue. A significant percentage of medical claims are denied or delayed by the payers due to incorrect or inadequate coverage details, that could be properly addressed by having an efficient eligibility and benefits verification process. Beyond the financial implications, accurate insurance verification supports the referral and prior authorization processes, and helps patients understand their financial obligations.
We, at RCM Workshop, understand the importance of eligibility and benefits verification for your business and have established an efficient solution to gather correct information on a patient’s coverage, benefits, and co-payments to determine patient’s financial responsibility and submit clean claims subsequently.
Our Eligibility and Benefits Verification Process
Our billing experts identify diligently validate coverage and benefits provided by both the patient’s primary and secondary payers, thereby defining the financial accountability for the intended healthcare service. This step also involves identification of prior authorization requirements for the service.
- Confirm the patient’s eligibility for insurance benefits
- Determination of prior authorization and referral requirements
- Identify the primary and secondary payers
- Evaluate out-of-network benefits if the practice is not within the insurance plan
- Verify the patients' coverage, co-pays, co-insurance and deductibles
- Patient follow-up to seek any missing or incorrect information
BENEFITS
Outcomes Guaranteed
Eligibility and benefits verification is an important step to ensure clean claim submission at the first time and reduce rejections. Improved clean claim submission on time leads to faster claim adjudication at the payer’s end. Our service assists in improving efficiency in your revenue cycle and ensures correct and timely reimbursement.
less claim rejections
Submission of clean claims first time
Increased self-pay revenue
Correct determination of patient’s responsibility
Improved revenue
Increased clean claim submission
improved cash flow
Reduced denials
improved turnaround time
Promptness and efficiency of service
improved patient satisfaction
Efficient billing & payment process
WHY US?
Why partner with us
Our eligibility and benefits verification process is part of our comprehensive Revenue Cycle Management solution and ensures accuracy of patient insurance details to support a very efficient revenue cycle process. Our eligibility experts work closely with your team and proactively perform the tasks involved with an exceptional turnaround time. The entire process is expertly overseen and proactively monitored to ensure the delivery of high-quality outcomes. Seize the opportunity to enhance your revenue cycle – partner with us today for exceptional results.