Eligibility Verification and Prior Authorization Services from Access Healthcare
Eligibility and benefit verification is vital to ensuring accurate and timely receipt of information regarding insurance coverage, and determining the patient’s responsibility to pay for healthcare services. Even then, many healthcare providers do not pay the needed attention to eligibility and benefits verification process. Accurate and timely determination of the patient’s eligibility provides healthcare providers a clear view on patient’s coverage, out-of-network benefits. and accurate insurance information. Incorrect insurance information could result in delayed payment at best, or denial at worst.
Performing eligibility verification helps healthcare providers submit clean claims. It avoids claim resubmission, reduce demographic or eligibility related rejections and denials, increase upfront collections; leading to improved patient satisfaction. Also, verifying authorization requirement before the service avoids denials, and contributes to increase in collections. Leverage Access Healthcare’s Eligibility Verification and Prior Authorization services to optimize your revenue cycle and improve collections.
Eligibility and Benefits Verification Services
We receive our workflow through the patient scheduling system, EDI, Fax, emails, and FTP files
We verify primary and secondary coverage details, including member ID, group ID, coverage period, co-pay, deductible / co-insurance information, and benefit information
We use the best channel (call or web) to connect with the payer
We perform automated eligibility verification using our RPA tools
Access Healthcare's prior authorization team is adept at:
Determining prior authorization requirements
Preparing and submitting requisite information to the payer
Following up on submitted prior-authorization requests
Notifying the providers in case any authorization issues are identified
Access Healthcare’s Value Proposition for Eligibility Verification and prior authorization services
Optimize cash flow
Reduce patient related denials
Avoid rejection of claims by payers due to inaccurate or incomplete information
Identify the patient’s responsibility upfront
Improve patient satisfaction
Process Automation solutions
Contact us to learn more about Access Healthcare's Eligibility Verification and Prior authorization Services
Global collaboration is key
Outsourcing a part of your business in any way, especially offshore, can be a very scary decision. Access Healthcare’s best practices engine and arc.in platform give you peace of mind and complete transparency into the process.