Consistent Verification
To Ensure Accuracy

Eligibility & Benefit Verification

A patient's eligibility and benefits can change at any moment. Lack of follow up with insurance carriers prior to 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
  • Co-pay
  • Deductibles
  • Co-insurance
  • Claims mailing address
  • Referrals & pre-authorizations
  • Pre-existing clause
  • Max-daily benefits
  • Life time 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.