Eligibility & Benefit Verifications

Eligibility & Benefit Verifications

According to the survey report mostly practice revenue burns due to insurance-coverage and member benefits.  A lot of claims are denied because eligibility and benefit not verified or the patient or service not covered by the plan or providers. A huge revenue can save if the practice establishes an insurance verification process in the office or get the services from a professional organization. Our eligibility and verification team can reduce these types of denials, making medical billing practices more efficient and raising your overall bottom line revenue. Patient benefit and insurance eligibility should be verified before clinical services are provided and should never be a task the medical billing staff handles on the back end.

Eligibility-&-Benefit-Verifications

Our trained and experienced special team will guide and assist you on patient eligibility and benefits services with custom designed sheets. We took the patient eligibility and benefit according to the client’s demands.
We highly recommend and encourage all healthcare providers to use the Availity, Navi-Net Provider Portal or their preferred vendor for eligibility and benefit verifications tools and get benefit information from the member services help line via phone or IVR.

Our Eligibility & Benefit Verifications Process

Our staff check member eligibility with insurance card and also view detailed benefits information. We also confirm all details such as Group Number, Group Name Plan/Product, Current Effective Dates, Co-payment Co-insurance, Deductible (original and remaining amounts), Out-of-pocket Limitations/Maximums Preauthorization indicators and contacts.

  • Search benefits by category, including vision
  • Get a copy of the digital ID card
  • Check coverage limits and therapy accumulators
  • Verify the care provider’s network and tier status for the member’s plan
  • View cost share amounts and balances
  • Learn more about Eligibility and Benefits
  • Member ID Cards Verification
  • Identify Member’s Primary Care Provider (PCP)
  • View, Add Notes or Comment on Member’s Plan of Care
  • Access / Acknowledge Member Health Assessment
  • Access Member Health Risk Assessment
  • View Risk Stratification Assessment
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