Eligibility & Verification of Benefits

Eligibility and insurance verification are vital to ensuring accurate and timely receipt of information regarding insurance coverage and determining the patient’s responsibility to pay for healthcare services. Even then, many healthcare providers do not pay the needed attention to the eligibility and verification process. Accurate and timely determination of the patient’s eligibility provides healthcare providers with a clear view on patient’s coverage, out-of-network benefits. and accurate insurance information. Incorrect insurance information could result in delayed payment at best or denial at worst.

Performing eligibility verification helps healthcare providers submit clean claims. It avoids claim re-submission, reduces demographic or eligibility related rejections and denials, increases upfront collections; leading to improved patient satisfaction. Also, verifying authorization requirements before the service avoids denials, and contributes to an increase in collections. Leverage Medheave’s Eligibility Verification and Prior Authorization services to optimize your revenue cycle and improve collections.