Eligibility Verification Services
Get your insurance verification optimized by expert physicians with enhanced patient experience, designed to boost care and reliability
By verifying the eligibility and insurance coverage of a patient before their appointment can prove to be an important step in the healthcare revenue circle, providing cash flow that is flawless and timely. A study by the American Cancer Society has shown that 66% of denied claims are caused by eligibility issues, indicating what financial risk we can face if this step is overlooked. Despite being an important aspect of medical billing, eligibility verification is under prioritized, responsible for costly delay and revenue decrease.
What are the impacts of ineffective eligibility services?
Increased Claims Denials
Failing at verifying a patient's coverage can cause rejection of claims or complete denials that can be a leading cause of late payouts with increased burden of administration.
Cashflow With a Negative Impact
With payments that are irregular and completely missed due to eligibility issues, can cause an interference in the revenue cycle. These hurdles can eventually make it tough for providers to stay financially stable and mobilize their cash flow.
Flawed Patient Experience
Without checking the eligibility properly, patients can often face surprise costs that are out-of-pockets as their insurance might fail to cover the received services, causing frustration, lack of managing funds and loss of trust in the provider.
Late or Lost Revenue
With no focus on eligibility, providers can lack at delivering non covered services,causing a delay at reimbursement or not payment at all.
What Sets USA MedWorks Apart
Clean claim rate
HIPAA & CMS Compliant Systems
Custom Solutions
Transparent Reporting Access
What is USA MedWorks Approach to Eligibility Verification?
- Patient Scheduler Integration:
It is straightforward to plan and execute the process of verification when patients’ schedules are obtained straight from the healthcare provider.
- Accuracy of Demographic Information Entry:
Our team of professionals works hard to ensure that they make an accurate entry of demographic details of the patents they deal with as it can be a crucial aspect when its comes to verifying benefits and eligibility.
- Thorough Coverage and Benefit Evaluation
- Management of Insurance Intricacies:
Double eligibility, external party eligibility and other state verification are some of the hurdles that can be faced when it comes to verification.
- Benefits of In and Out Network:
Get patients liability established by assessing the chosen services are insured by in or out of network benefits.
- Updated System With Payer Information:
After the eligibility of the patient has been approved, we then add any necessary payers information to the healthcare providers revenue cycle system. This step is helpful to assure that all provider data is direct and up to date.
Get Required Information
By verifying the eligibility and insurance coverage of a patient before their appointment can prove to be an important step in the healthcare revenue circle, providing cash flow that is flawless and timely. A study by the American Cancer Society has shown that 66% of denied claims are caused by eligibility issues, indicating what financial risk we can face if this step is overlooked. Despite being an important aspect of medical billing, eligibility verification is under prioritized, responsible for costly delay and revenue decrease.