Eligibility Verification

Pre Insurance Eligibility Verification

A vital part of the medical billing process is the scrutiny and verification of the patient’s eligibility and benefits before scheduling the patient appointment. We call the payers regarding any payment responsibility the patient needs to fulfil prior or post the treatment. Our teams of expert Tele-callers carry out this verification process within 24hrs.

The details that our team verifies include: Effective date and coverage details

• Type of plan
• Payable benefits
• Co-pay Deductibles
• Co-insurance
• Claims mailing address
• Referrals & pre-authorizations
• Pre-existing clause
• Lifetime maximum
• Other related information

This information is collected and verified before the patient appointment date as it helps in getting referrals, prior authorization numbers, and optimizing the billing process, as well as preventing denials due to invalid benefits and eligibility reasons.

Once the verification process is completed and the patient visits the health care provider, treatment plans are generated.