We contend that a lack of effective checks and balances in this procedure may result in substantial revenue losses due to claim denials and delayed payments. In order to prevent such issues, we offer our clients early insights into a patient’s eligibility before the actual encounter. This data empowers healthcare providers to recommend a treatment plan that aligns with the coverage scope, clarifies out-of-network benefits, and outlines associated payment responsibilities.
Our proficient team manages the patient eligibility verification through expertise in checking coverage and benefits from payer websites and phone calls. We promise a standardized and swift verification and admission process for our clients.
ELIGIBILITY AND BENEFITS VERIFICATION SERVICES
Our services offer the following advantages to clients:
Diverse Workflow Channels: Receive workflows seamlessly via various patient scheduling systems such as EDI, Fax, emails, and FTP files.
Swift and Accurate Verification: Ensure rapid and precise confirmation of primary and secondary coverage details, encompassing member ID, group ID, coverage period, co-pay, deductible, co-insurance, and benefits information.
Efficient Payer Communication: Establish effective connections with payers through optimal channels.
Proactive Issue Resolution: Promptly identify and resolve missing or invalid data using Robotic Process Automation for enhanced speed and accuracy.
Comprehensive Patient Data Verification: Verify patient demographic and policy details, including benefits, deductibles, plan inclusions, and exclusions.
Pre-Certification and Approval: Obtain pre-certification numbers and secure approval for benefits verification.
System Update: Verify patients’ coverage, co-pays, co-insurance, deductibles, and claims mailing addresses on primary and secondary payers, updating the revenue cycle management system.
FIRSTVERTEX’S VALUE PROPOSITION FOR ELIGIBILITY VERIFICATION SERVICES
Our services offer the following benefits:
Optimized Revenue and Cash Flow: Maximize revenue streams and enhance cash flow.
Reduced Denials: Mitigate denials related to patient information.
Global Cost Savings: Realize cost efficiencies through global delivery.
Data Accuracy Assurance: Provide confidence in accurate and complete data.
Reduced Rejections: Experience fewer rejections due to information issues.
Upfront Patient Responsibility Clarification: Clarify patients’ responsibilities upfront.
Enhanced Patient Satisfaction: Improve patient satisfaction levels.
Elevated Quality Standards: Ensure improved quality in service delivery.
