Eligibility and benefits verification is a core function of the revenue cycle, designed to ensure that providers receive accurate payment and patients clearly understand their financial responsibility. Verifying insurance details prior to services being rendered significantly reduces claim denials, delays, and surprise billing for patients.
Contact us nowWe offer a comprehensive suite of verification services to ensure you get paid faster, reduce denials, and improve patient satisfaction.
We leverage both real-time automated tools and manual outreach to verify insurance coverage across all major commercial and government payers.
Our team verifies eligibility and benefits for every scheduled patient a day or two before their visit. This gives your front office staff accurate, up-to-date information for patient intake.
All verified insurance and benefit details including co-pay, deductible, co-insurance, and authorization notes—are documented directly in your electronic health record (EHR) or practice management system (PMS)
We manage and monitor pre-authorization requests from submission to approval. Our team follows up with payers, keeps your staff informed of status changes.
We specialize in delivering comprehensive, results-driven denial management services. Our mission is to recover lost revenue, reduce future denials, and strengthen your entire billing workflow allowing you to focus on what matters most: patient care.
We contact payers to verify the patient’s active insurance coverage, policy details, and plan status. This ensures that providers are billing the correct payer and helps avoid unnecessary claim rejections.
Certain procedures require prior authorization. Our team confirms whether authorization is needed, obtains approvals, and coordinates with referring providers as needed ensuring compliance before the service date.
We identify which medical services, treatments, or procedures are covered under the patient’s plan and which ones are excluded or require prior approval helping reduce unexpected billing issues later.
We calculate and communicate patient responsibility such as co-pays, deductibles, and co-insurance. This empowers your front desk to collect payment upfront and improves patient transparency.
If a patient has multiple insurance plans, we determine the correct order of billing and ensure claims are directed to the appropriate primary or secondary payer avoiding delays and denials.
Using integrated clearinghouse and EDI tools, we perform real-time eligibility checks—reducing turnaround times and giving staff immediate access to benefit data right before appointments.
Contact Denial Management today at (281)-864-0448 to get started. Let our experts handle your provider enrollment and re-credentialing tasks, so you stay compliant and get paid faster.