Eligibility and Benefits Verification
What service we provide in Eligibility & Benefits Verification?
Inadequate verification leads to issues like delayed payments, reworks, and decreased patient satisfaction. We ensure accurate and one-time eligibility verification so you can focus on what matters most—your patients.
Our comprehensive insurance eligibility verification services include:
• Documentation or updating patients’ demographic data.
• Verification of patient insurance coverage details on primary and secondary insurance carriers.
• Confirmation of authorization for treatment, if required.
• Determining the collection of co-payment, co-insurance, or deductibles.
• For patients aged 65 or older, we verify Medicare eligibility.
• Ensure referrals are approved and updated in the system.
By Eligibility & Benefits Verification, we can ensure:
• Minimizing delays in payments and Eligibility & benefits related denials.
• Improving patient satisfaction.
• Increased revenue and cash flow.
What is Eligibility & Benefits Verification?
Eligibility and benefits verification is the process of verifying a patient’s health insurance coverage and benefits to determine what services are covered and the level of coverage available.
This process ensures that the provider receives payment for services rendered and the patient receives the appropriate level of care without any financial surprises.
During patient registration, provider’s office collect information such as the patient’s insurance policy, the name of the insurance company, the type of plan, and the patient’s co-payment, coinsurance and deductible amounts. This information is then used to confirm that the patient is eligible for medical services and to determine the level of coverage available for those services and also patient responsibility if any.