PATIENT ACCESS
Eligibility & Benefits Verification
Confirm eligibility and benefits up front, reduce denials, and speed up patient access to care.
75%
Denials tied to eligibility issues
Faster
Speed to care
Fewer
Denied claims
Eligibility & Benefits Verification Services
In healthcare, it's crucial for providers to confirm a patient's eligibility and coverage for services before their appointment. This verification process is a key part of ensuring successful payment for services rendered — statistics show that up to 75% of denied claims can be attributed to patients not being eligible for the services provided.
Impact of Ineffective Eligibility and Benefits Verification
When eligibility and benefits verification is not conducted effectively, it can lead to increased claim denials, delayed payments, additional administrative rework, patient care delays, and decreased patient satisfaction.
Our Approach to Eligibility Verification
By conducting comprehensive eligibility and benefits verification, we aim to streamline the revenue cycle for healthcare providers, enhancing both provider and patient experiences.
✓
Patient Schedule Integration: Directly receiving patient schedules from the provider's office helps plan and organize the verification process efficiently.
✓
Accurate Demographic Information Entry: Our team ensures precise entry of patient demographic details, fundamental to verifying eligibility and benefits correctly.
✓
Comprehensive Coverage Verification: We handle dual eligibility, third-party eligibility, and out-of-state verifications with ease.
✓
In-Network and Out-of-Network Benefits: We determine whether services are covered in-network or out-of-network, providing clarity on patient liability.
✓
System Updates with Payer Details: After verifying eligibility, we update the practice's revenue cycle system with all relevant payer details.
Why Providers Choose Our Eligibility Verification Team
By outsourcing eligibility verification to us, healthcare providers can prioritize patient care over administrative tasks and minimize errors and delays.
Efficient processing of eligibility requests accelerates scheduling for care reviews, leading to enhanced patient satisfaction and better physician utilization.
Processing eligibility verifications efficiently reduces claim denials and accelerates cash flow.
Upfront determination of patient responsibility improves point-of-service collections and patient satisfaction.
We work with all major commercial and government payers — BCBS, Aetna, Humana, United Healthcare, and more — across multiple specialties and practice sizes.
In-house verification can be costly — our dedicated team processes each request diligently, reducing overhead.
PROVEN ELIGIBILITY VERIFICATION OUTCOMES
Real Results From Patient Access Clients
Get Our Latest Thinking
CONNECT WITH US:
Ready to Stop Losing Revenue to Eligibility Denials?
Enhance your patient care by establishing a high-performance revenue cycle with our expertise in eligibility and benefits verification. Simply fill out the form, and one of our specialists will promptly reach out to assist you.
Talk to an Advisor
Please note, if you are interested in careers, click here to visit our career page.
To learn more, visit our Privacy Policy.