Insurance Eligibility and Verification

Insurance Verification

Irrespective of patients' integrity in disclosing factual information about their health insurance plans, it has been our first-hand experience that the physician reimbursement rate is directly linked to the quality of Insurance Verification adopted by their medical billing staff. The realization has given rise to a comprehensive Insurance Verification process that is quite capable of verifying the factual information furnished by the patients during their enrollment for medical service.

As you consider adapting Verification Process that is capable of serving your comprehensive needs, our unique Insurance Verification following a streamlined questionnaire should prove to be an ideal choice:

• Does the patient have an effective health plan with the insurance carrier?
• What is the effective date of coverage?
• What type of plan is the patient covered under – HMO, PPO, or POS?
• What is the patient's co-payment responsibility?
• Does the patient have a deductible? If yes, how much is the deductible and how much of the deductible has been met?
• Does the patient have other out-of-pocket expenses?
• Does the patient have medical benefits for treatment?
• Does the treatment require prior-authorization?
• What is the prior-authorization dept. phone number? Who is your primary contact?
• Is a referral from the primary care physician or other referring physician required?
• Does the referral have to be submitted to payer prior to rendering services?
• Where should you submit the referral?
• How do you establish the factuality of patients' addresses?

Consequent to such streamlined Insurance Verification you can expect your claims to be delay and denial free, and less prone to stringent audits by your insurance carriers. Thus, our ingenious Insurance Verification – offered both as a separate component as well as integral part of our comprehensive suite of Medical Billing Revenue Cycle Management – will eventually bring down your Account Receivable Cycle within the permissible limit, prove operationally viable, enhance revenue generation, and foster quality medical care.

Our qualified and competent team of medical billing specialists, comprising a diverse mix of professionals drawn from different specialty-specific disciplines, will make sure that you have your patients insurance plans thoroughly verified against intended medical services.