Eligibility and Benefits Verification

At Access Healthcare, we understand that comprehensive eligibility and benefits verification processes are critical for providers to provide prompt, accurate, and thorough information about a patient's insurance coverage. Our Eligibility and Benefits Verification Services assist healthcare providers in making informed decisions about the nature of care given, medications prescribed, and further diagnostics, particularly in elective and non-emergency procedures, based on the patient's eligibility.


We believe the absence of proper checks and balances in this process can lead to significant revenue leakages through denials and delayed payments. To avoid this, we provide our clients with insights into the patient's eligibility upfront before the actual encounter. This information helps healthcare providers suggest a course of treatment aligned with the scope of coverage, classification of out-of-network benefits, and resultant payment obligations.

Our skilled team of experts handles the patient's eligibility verification process. They have the expertise in confirming the patient's coverage and benefits from individual payer websites and making phone calls. We assure our clients of a standardized eligibility verification and admission process and guarantee quick turnaround.

ELIGIBILITY AND BENEFITS VERIFICATION SERVICES

Our Eligibility and Benefits Verification Services offer the following benefits to our clients:

  • Flexible channel for receiving workflows through various patient scheduling systems - EDI, Fax, emails, and FTP files.

  • Fast and accurate verification of primary and secondary coverage details, including member ID, group ID, coverage period, co-pay, deductible, and co-insurance and benefits information.

  • Efficient connection with the payer using the best possible channels.

  • Prompt identification and resolution of missing or invalid data.

  • Robotic Process Automation for improved speed and accuracy.

  • Verify patient demographic and policy information, including benefits, deductibles, plan inclusions, and exclusions.

  • Obtain a pre-certification number and get approval for benefits verification.

  • Verify the patients' coverage, co-pays, co-insurance, deductibles, and claims mailing addresses on all primary and secondary payers and update the revenue cycle management system.

  • Flexible channel for receiving workflows through various patient scheduling systems - EDI, Fax, emails, and FTP files

  • Fast and accurate verification of primary and secondary coverage details, including member ID, group ID, coverage period, co-pay, deductible, and co-insurance and benefits information

  • Efficient connection with the payer using the best possible channels

  • Prompt identification and resolution of missing or invalid data

  • Robotic Process Automation for improved speed and accuracy.

  • Verify patient demographic and policy information, including benefits, deductibles, plan inclusions, and exclusions.

  • Obtain a pre-certification number and get approval for benefits verification.

  • Verify the patients' coverage, co-pays, co-insurance, deductibles, and claims mailing addresses on all primary and secondary payers and update the revenue cycle management system.

ACCESS HEALTHCARE'S VALUE PROPOSITION FOR ELIGIBILITY VERIFICATION SERVICES

Our Eligibility Verification Services provide the following benefits to our clients:

  • Optimal revenue and cash flow.

  • Reduced patient information-related denials.

  • Cost savings from global delivery.

  • Assurance of accurate and complete data.

  • Fewer rejections for information issues.

  • Upfront clarification of the patient's responsibility.

  • Improved patient satisfaction.

  • Improved quality.

Contact us to learn how your organization can leverage Access Healthcare’s Prior Authorization Services.

Leverage Access Healthcare's expertise in Eligibility Verification to optimize your revenue cycle .

Talk to us about how:


Global collaboration is key

In today’s competitive environment, your healthcare organization should be considering a global outsourcing strategy.  However, it is critical to carefully evaluate various options to achieve optimal results for your company with the least risk. 

You are encouraged to view our white paper: 9 things to look for in a Revenue Cycle Services Provider.


Featured Content