Toll Free 888-357-3226

How can Accurate Eligibility Verifications Help in Reducing Denials?

November 19, 2012

Non-verification of insurance eligibility may lead to several problems - delayed payments, rework, increased errors and patient dissatisfaction - making it essential to do accurate insurance verification much before starting the medical billing process.

Industry Facts

  • Improper verification of insurance can increase claim denials
  • One in every five medical claims are processed inaccurately by health insurers
  • Health insurance industry as a whole has about 80% accuracy rate for processing & paying claims
  • 1% improved claims processing accuracy creates an estimated savings of $777.6 mn. in unnecessary administrative cost

Hence physicians need to make every effort to ensure accuracy especially during eligibility verification which is the beginning of the medical billing process

Why Insurance Eligibility Verification? - It Improves the AR Cycle

Standard procedure of checking insurance eligibility of the patient helps in:

  • Identifying patients who have - changed carriers, have pre-existing exclusions or large deductibles
  • Improves patient relations as your patients will be prepared, in advance, of their financial responsibility
  • Immediately increases your cash flow by collecting patient portions at time of service
  • Sorting any disputes later with the insurance company over when or if the eligibility verification occurred

Implementing automatic eligibility verification

  • Electronic verification can eliminate up to 50% of denials & offers staff more time to concentrate on other tasks.
  • A practice can save nearly $4,000 in costs per physician by using electronic eligibility verification.

An accurate eligibility verification process at your practice!

Following a proper process for eligibility verification can help in reducing denials and improving revenue flow. But physicians limited by time restraints and to ensure maximum benefits for the practice, will benefit by teaming up with a good service provider.

Outsourcing Health Insurance Verification = Reduced Rejections and Denials!

MBC’s Insurance eligibility verification services mainly include:

Payable benefits Patient details Co-pays Pre-authorization no.
Co-insurance details Deductibles Effective date Patient policy status
Type of plan & coverage Plan exclusions Claims mailing address Referral & pre-authorization

With your Eligibility verifications taken care of by MBC -helps you concentrate on patient care without worrying about denied claims & reimbursement issues

Advantages of eligibility verifications with MBC

Improve cash flow Reduce costs (30 - 40% below operational) Increase efficiency Increase upfront collections
Reduce claim denials Reduce lost revenue in collections Increase staff productivity Increase patient satisfaction
Increase number of clean claims Assistance in providing improved patient care Reduce the time spent following up on claims Increase office efficiency
Quick approval Workflow simplified Chances of risk reduced Quicker billing cycles

MBC has been providing Insurance Verification – offered both as a separate component as well as integral part of our comprehensive suite of Medical Billing Revenue Cycle Management – which has helped in eventually bringing down our clients AR Cycle and enhanced their revenue generation.

Our qualified and competent team of medical billing specialists will make sure that you have your patients insurance plans thoroughly verified against intended medical services. Additionally in keeping with the changing trends we have also been offering our physicians assistance with electronic eligibility verifications assisting them with increased savings.


Category : Accounts Receivables / Claims Denials