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Insurance Eligibility and Verification


How it works?

Physicians across the nation have been struggling to find a professional who can relieve them of their administrative chores so that they can face the challenges of providing quality healthcare. Most physicians would rather prefer a specialist taking care of the reimbursement process and maximize their revenue but they are tirelessly looking for the rest to manage their revenue cycle management.

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.

Real Physicians, Real Results

Discover how physician groups thrive with us

We had no visibility into whether our IPA capitation payments were accurate. MBC's reconciliation process identified $138,000 in underpayments in the first quarter. That's revenue our prior vendor never even looked for.

Dr. S. Larsen
Dr. S. Larsen
Wound Care Practice — San Diego, CA

“I appreciate your prompt results on my Medicare inquiry. Dr. Ingrid Arnold and I appreciate the quality work that you and your team have provided to her practice. We had tried a couple of different insurance posting options, before we contracted with your company. We are delighted that we found your company to assist us. We find your reports timely and informative. I will recommend your services, without reservation, to any of our physician friends, who might be looking for a more reliable billing service”

Dr. Ingrid Arnold
Dr. Ingrid Arnold
DO | Mesquite, Texas

“I want to thank you for your professional help during the past two years with our accounts receivable. I have absolutely nothing but appreciation for your company in helping us out with the jam we were in when our office manager suddenly quit. Since that time we have enjoyed an absolutely non-problematic relationship. Our experience with claims injury, handling insurance rejections, posting our payments, the account receivable process, patient statements, and the excellent service provided to my patients are greatly appreciated. I also sincerely appreciate all the help that you have given me and my staff and I wish you the best of luck in future endeavors.”

Dr. Larry C. Watson
Dr. Larry C. Watson
MD | Houston, Texas

“For the last 4 years, MBC has been an integral part of growing our counseling and Intensive outpatient programs. My team and I appreciate MBC's commitment to exceptional customer support, credentialing, and billing services.”

Dr. Allen
Dr. Allen
Texas

Record high collections this month for our Chiropractic Practice! Thank you MBC!

Dr.Faulds
Dr.Faulds
Alabama

I just wanted to take a moment to say a big thank you for all the hard work you've put in over the past two years! Your efforts have really helped us transform our old accounts receivable into the impressive numbers we see today. I truly appreciate everything you do to keep our operations running smoothly all year round. Let’s keep up the great work together as we continue to tackle past claims and stay on top of the current ones.

Vadim Vartanov
Vadim Vartanov
Internal Medicine Associates of Jacksonville, FL

“We truly appreciate the exceptional work you are doing. Dr. Martha and I are grateful for your dedication and commitment. Your availability, regardless of the time, has been invaluable to us. The outstanding results we've achieved are a testament to your efforts, and we hope to continue this successful journey together. Thank you for all that you do!”

Judith Cedeno
Judith Cedeno
Podiatry Office Manager, FL

“Just a note of thanks in appreciation of all your help. The credentialling process can be daunting but you and the team at MBC were awesome every step of the way. Communication was clear, the process moved efficiently and the service was stellar. Thanks again and I look forward to working with you on this journey.”

Dr. Michael Lacqua
Dr. Michael Lacqua
Plastic & Reconstructive Surgeon, NY

“Our billing was poorly organized with a poor collection rate before you took on our account, and you have worked diligently to find what can be paid and have organized our billing process, including the sometimes difficult workers comp cases which compose a lot of my billing. Your unflinching attitude to constantly find ways to improve our billing is beginning to pay off. We are optimistic that with continued improvements and refinements we will see a big boost in our collections, and we are looking forward to a big turnaround in our finances in 2025 working with you. Thank you for your unstoppable attitude.”

Dr. James Baker
Dr. James Baker
Orthopaedic Surgeon | Knee and Hip - Stryker, TX
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