Patient Eligibility Verification

Patient Eligibility Verification

Verification of Benefit & Coverage is the most critical part of medical billing process; it is single most effective way of preventing insurance claim denials & securing payments.

Research confirms that most of the claims are denied or delayed due to inadequate or incorrect coverage information provided by the patients during visits and current coverage information not updated by the office / hospital staff. This makes it difficult for practices to determine whether the patient is eligible for benefits without verifying with the payer. This lack of or improper insurance eligibility verification directly impacts the reimbursements.

Let us handle the time consuming collecting information on a patient's eligibility prior to a medical service, Our Staff would check the insurance eligibility and benefits, through the web as well as through the phone and any types of coverage issues prior to patient treatment, we would update the practice so that they would discuss the payment options with the patients at the time of appointment

Details that THS team would verify:

• Patient Demographics as per Insurance
• Effective date and coverage details
• Plan Type
• Copay
• Deductibles
• Co-Insurance
• Benefits Covered
• Claim Mailing Address & Payer Id's
• Pre-Authorization/Referral Requirements & other required information.

All of this information is collected and verified couple of days before the patient appointment date as it helps in getting referrals, prior authorization numbers, and optimizing the billing process, as well as preventing denials due to invalid benefits and eligibility reasons.