Insurance Eligibility & Verification
Accurate, fast, and compliant insurance eligibility checks to ensure smoother billing cycles, reduced denials, and better patient satisfaction.
The Importance of Insurance Verification
Insurance eligibility and verification is a critical step in medical billing. Without it, providers risk claim rejections, delays in payments, and compliance issues.
Our team ensures that every patient’s coverage details are verified in real-time, enabling providers to offer care with confidence while avoiding financial setbacks.
Insurance Eligibility
Insurance eligibility ensures that a patient is actively covered under their insurance policy before services are rendered. This step prevents financial losses, builds transparency with patients, and reduces claim denials significantly.
- Real-time verification of policy details
- Ensures coverage is active and valid
- Eliminates uncertainty at the point of care
Insurance Verification
Insurance verification is more than eligibility — it confirms patient benefits, coverage limits, co-payments, and pre-authorization requirements. This step ensures providers and patients are fully aware of financial responsibilities.
- Validate coverage limits & service inclusions
- Identify pre-authorization needs in advance
- Provide patients with clear cost transparency
Our Process
Collect Patient Information
We begin by gathering accurate demographic and insurance details including policy number, group ID, and payer details. This ensures all required information is on file before verification.
Contact Payers
Our team communicates directly with insurance providers through secure channels (online portals, EDI, or phone) to verify active coverage, copays, and deductibles.
Eligibility Confirmation
We cross-check and validate benefits including effective dates, coverage limits, exclusions, and pre-authorization requirements, ensuring patients are eligible for services.
Financial Responsibility
Estimated patient responsibility is calculated (copays, coinsurance, deductibles) and shared with providers, minimizing billing surprises and rejections.
What Our Clients Say
"We’ve seen a 40% improvement in claim acceptance rates since partnering with them."
"Our claim denial rate dropped significantly after adopting their eligibility verification services."
95%
Fewer claim denials
99.9%
Data Accuracy
2x
Faster Verification Speed