Insurance Verification | Eligibility Authorization

 

Get your Claims acknowledged on the first Submission 

Insurance verification and eligibility authorization process are the most critical and the initial phase in the medical billing and income cycle. According to industry experts, most of the claims are denied or delayed because of inadequate or incorrect coverage data given by the patients amid visits and also because the current coverage has not been updated by the in-house clinic staff. Due to such lack of information regarding the patient’s insurance verification, doctor’s tend to lose on reimbursements. This is where we at Insurance Verification Specialists come into play and offer our valued services to get the job done for the doctor’s facility.

 

What is the need and benefit of Insurance verification and eligibility authorization? 

Insurance agencies routinely roll out policy changes and rewrite their health plans. Along these lines, it is critical for the medical billing organization or the provider to check if the patient is covered under the new arrangement to get maximum repayment. Affirming healthcare coverage encourages acknowledgment of claim on first submission itself. While non-verified claims lead to several inconveniences like rework, decreased patient satisfaction, and distorts revenue cycle, increasing delayed and denial claims.

At Insurance Verification Specialists we understand the importance, Insurance verification and eligibility authorization can help Physicians facility with: 

  • Improved Collections, while reducing write-offs
  • Minimize the delays and denials drastically
  • Help the doctor’s office in reducing the overall revenue cycle

Also, our dedicated team helps you in each step of eligibility authorization like:

 

  1. Getting Schedules of patients by EDI, email or fax or check them consistently in the appointment scheduling software.
  2. Confirm patients' healthcare coverage with primary and secondary payers by making calls to them and checking through authorized portals. We likewise contact patients for extra information, if required 
  3. Update the medical billing framework with verification details, for example, “Patient name, MRN, DOS, Insurance, DOB, Insurance ID Group, Insurance Plan Type, Patient effective dt, Patient Termination dt, In Network/Out of Network, Referral Valid Dates, Authorization/referrals, Co-pay, Deductions, Co-insurance, Out of pocket expenses, Insurance Representative Name, Call Reference No, Date Verified”
  4. If there are any concerns with regards to a patient's qualification, we inform the doctor’s office immediately.