A patient's eligibility and benefits can change at any moment. Lack of follow-up with insurance carriers before seeing a patient could lead to an increase in claim denials and a significant loss of revenue. Maintaining a consistent and accurate verification process is essential to maintaining a healthy revenue cycle. Our eligibility and benefit verification specialists routinely follow up with the insurance carriers to ensure that patient information is up to date and accurate at the time of the visit.
We verify a wide range of data:
- Effective date and coverage details
- Individual patient eligibility
- Type of plan
- Payable benefits
- Non-covered procedures
- Claims mailing address
- Referrals & pre-authorizations
- Pre-existing clause
- Max-daily benefits
- Lifetime maximum
- Other related information
Our verification process checks procedure-specific coverage and benefits along with all out-of-pocket costs so that patients are aware of what is due before their visit. This process provides on-time patient payments and prevents unnecessary back-end collections, effectively increasing patient satisfaction and maximizing revenue.
Robotic Process Automation for Eligibility & Benefit Verification
A large physician practice based out of the midwest had issues with front desk processes that impacted their revenue cycle operations.