Patient Eligibility Verification
Helping health care providers in submitting clean claims
Claim Denials Avoided
By outsourcing pre-authorization and eligibility verification, you can focus on your bottom line and minimize errors that lead to claim denials.
Low Operational Costs
We understand that in-house verification can be expensive. Our services offer an affordable and cost-effective alternative.
Scale Your Business
Our eligibility verification services empower physicians with the critical leverage needed to scale their practices effectively.
Improve Patient Care
By streamlining the initial phase of revenue cycle management, we allow practices to prioritize patient care, enhancing overall patient satisfaction.
Our Pre-Authorization and Eligibility Verification Services Are All You’ll Ever Need!
Patient eligibility verification is a crucial initial step in revenue cycle management, allowing medical practices to determine whether a patient qualifies for treatment. This process includes breaking down benefits and confirming whether the healthcare service is covered by the patient’s insurance, along with other options such as copays, deductibles, and coinsurance.
Eligibility verification is vital for the overall success of a medical practice. Reports indicate that around 70-75% of claim denials stem from errors in patient eligibility verification by healthcare providers. This highlights that many practices are not giving adequate attention to their eligibility verification processes, resulting in claim delays and denials.
At HealthSync Billing Services, we offer a solution. Our eligibility verification services for physicians and private practices are designed to give you a competitive edge in the medical billing landscape.
Why Work With Us?
We are a leading medical billing company providing comprehensive RCM solution at cost-effective rates.
- 99% claim acceptance rate
- 100% HIPAA compliant process
- Affordable and Flexible Billing Plans
- Robust practice medical billing audits
- Enhance cash flow and reduce billing errors
Get Free Consultation
Eligibility Verification Is More Important Than You Think!
Many physicians and private practices view eligibility verification as a mere formality, often overshadowed by other steps in the revenue cycle management process. This misconception leads to a high rate of claim denials resulting from errors in patient eligibility verification. To make matters worse, these denials are often non-appealable and irreversible, categorized as hard denials. As a consequence, medical practices face financial losses and significant damage to their overall reputation.
Why Outsource Eligibility Verification Services
As mentioned earlier, eligibility verification is the crucial first step in the medical billing process. A practice can only receive timely payments if insurance verification is conducted accurately. It’s essential to verify a patient’s eligibility before providing any services. Failing to address eligibility verification promptly can result in delayed payments and increased claim denials, ultimately leading to reduced revenues.
This is where our eligibility verification services come into play. By outsourcing this task to our experts, you can focus on providing excellent patient care while ensuring your billing process runs smoothly and efficiently.
We offer specialized services for a wide range of specialties across all 50 states in the USA. Contact us today to take advantage of our expertise!
A Medical Billing Service You Can Trust!
At HealthSync Billing Services, we follow a comprehensive process for patient eligibility verification to expedite your accounts receivable cycle. Our experts confirm a patient’s eligibility through a detailed breakdown of benefits and secure the necessary prior authorization before the patient visits the physician’s office.
Our verification process includes the following steps:
Receive Patient Schedules
We start by obtaining patient schedules from clinics, hospitals, or medical provider offices.
Enter Patient Demographics
Next, we input the patient’s demographic information into our system.
Breakdown of Benefits
We conduct a thorough breakdown of benefits with both the primary (on the date of service) and secondary payers (including co-pays or coinsurance).
Initiate Prior Authorization Requests
Our team then initiates requests for prior authorization and secures approval for the prescribed treatment.
Update Revenue Cycle System
Finally, we enhance the medical practice’s revenue cycle system with the information obtained from the payers.
Eligibility Verification FAQs
Why is eligibility verification necessary for medical practices?
Medical practices need to ensure that the healthcare services they provide are covered by the patient’s insurance. This is why eligibility verification is essential.
Why outsource eligibility verification to HealthSync Billing Services?
HealthSync Billing Services is a professional RCM billing company that guarantees accurate eligibility verification and a thorough breakdown of benefits, helping medical practices avoid claim denials that could impact their revenue.
What is meant by a Breakdown of Benefits?
The term “Breakdown of Benefits” (BOB) refers to the process of checking co-pays, deductibles, coinsurance percentages, and other non-covered amounts that patients are responsible for paying to medical practices or physicians.
How much time is needed for insurance verification?
Typically, the verification of benefits takes about 20 minutes. However, it is advisable to contact the payer 72 hours before the patient’s appointment for optimal results.
