Eligibility/Benefits Verification

Healthcare providers verify the eligibility and benefits of the patients before they visit. According to the research, 75% of the claims got denied because of patients' inactive insurance policies on the date of services rendered by healthcare providers. In the revenue cycle, this process is most neglected.

Patient Eligibility Verification Services USA

Patient Eligibility Verification Services

FS medical billing has a team of skillful people who can boost your receivable cycles. We ensure to verify the patient’s eligibility and take essential prior authorization before the patient visits the physician.

Our experts do the following for verification purposes.

  • Get the patient’s schedule from the healthcare provider’s office – hospital, or clinic
  • Call Insurance to get the updated patient eligibility verification services USA.
  • Verify coverage and benefits with the patient’s primary and secondary payers:
    • Coverage – Check if the patient has a valid range on the date of service
    • Benefit options – patient’s responsibility for co-pays, coinsurance, and deductibles
  • Whenever required, the team initiates prior authorization requests and takes approval for the treatment
  • After getting details from the payers, update the hospital’s revenue
  • cycle system or the patient’s practice management system

Effect of ineffective eligibility/benefits verification and prior authorization processes

One can face increased claim denials, non-payment of claims, dissatisfaction of patients, and delay in access to care for patients because of ineffective eligibility/benefits verification and prior authorization processes.