Patient Eligibility Verification
Real-time insurance verification at scheduling and check-in to prevent eligibility-related denials and surprise bills. Know exactly what is covered in advance.
First Line Of Denial Defense
Stop Eligibility Related Denials
Eligibility issues account for 25% of all claim denials. Our comprehensive services ensure you verify patient coverage before services are rendered, saving your practice time and money.
Comprehensive Verification To Protect Your Revenue
Why Our Verification Is Essential
When patients receive services without proper verification, it leads to bad debt and reputation damage. Our multi-point approach catches coverage changes early, ensuring accurate billing every time.
Our Systematic Operational Methodology
Strategic Implementation Process
Insurance Verification
Multi-Point Approach From Scheduling To Check-In
Beyond simple active/inactive status, we verify specific benefits like visit limits, primary vs. secondary coordination, and network status. This proactive monitoring ensures you collect the correct amounts at the point of service daily.
Coordination of Benefits Setup
Insurance Card Image Capture
Referral Requirement Alerts
The Result
Reduce eligibility-related denials by up to 70% and eliminate patient complaints regarding surprise bills through transparent quotes.
Coverage Changes
Automated alerts notify your staff immediately if a patient’s plan has terminated or changed.
Network Status
Confirm if the patient is in-network or out-of-network to provide accurate cost estimates fast.
COB Coordination
Determine primary and secondary billing order for multi-insurance patients to ensure accuracy.
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Denial Appeal Success
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Eligibility Denial Drop
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HR
Real-Time API Access
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Verified Batch Results
Prevent Surprise Bills
Trusted Verification Experts
Our technology integrates seamlessly with your EHR/PM system, reducing double-entry. We manage the complex research of terminated coverage and inactive policies so your staff doesn’t have to.
Common Questions About Eligibility Verification
Frequently Asked Questions
Understand how our verification process secures your front-end revenue cycle.
When should we verify coverage?
Verification should happen at three points: during initial scheduling, 24-48 hours before the appointment, and finally at check-in on the day of service.
What info do you verify for us?
We verify active status, effective dates, deductible remaining, copay/coinsurance amounts, prior authorization needs, and in-network vs out-of-network status.
How does this reduce denials?
By ensuring the patient has active coverage and the correct primary payer is identified before services, you eliminate the most common source of claim rejections.
Can you integrate with our EHR?
Yes, our system integrates with most major EHR/PM platforms, allowing verification results and current insurance data to flow directly into your existing patient records.
Ready to Optimize Your Medical Billing & Coding?
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Practices trust our HIPAA-compliant RCM.