21+
Years of Experience
500+
Practices Served
2,500,000+
Verifications Completed
Save Time with Our Insurance Verification Services
Insurance eligibility verification is one of the most critical steps in the medical billing process. Failing to verify policy details before an appointment can result in expensive claim denials, untimely payment delays, and administrative hassles. Our experienced verification specialists will help you stay ahead by verifying patients’ insurance coverage in real time – before they walk through the door.
We provide professional insurance verification services that streamline front-end operations, improve billing accuracy, and boost cash flow. Our team is well-versed in both government and commercial payer policies, making patient eligibility verification fast, accurate, and stress-free.
We support practices across all 50 states.
Benefits of Our Medical Insurance Eligibility Verification
- Enables smooth navigation of payer-specific policies
- Online and real-time verifications
- Hassle-free services to focus more on patient care
- Accurate coverage checks reduce costly billing errors
- Fewer denials and improved claims success rate
- Better point-of-service collections and reduced accounts receivable
- Improved patient satisfaction with upfront cost transparency
- Ensures compliance with insurance billing requirements
How Our Patient Insurance Eligibility Service Works
1
Patient Information
Collection
2
Insurance
Verifications
Verifications
3
PMS
Updates
Updates
4
Reporting
& Follow-up
& Follow-up
5
Stat Requests
Management
Management
Patient Information Collection
During registration, we collect requisite demographic and insurance information, including name, birth date, policy numbers and the reason for the visit. This ensures we start the insurance verification for medical billing with complete and accurate data.
Insurance Verifications
Before the patient’s visit, we verify:
- Plan type and policy number
- Coverage effective dates
- Co-pays, deductibles, and coinsurance
- Benefit limitations and exclusions
- Referral or authorization requirements
- Network participation status
We perform real-time verification using both online portals and live calls to the insurance company for deeper insight and confirmation of coverage.
Practice Management System (PMS) Updates
Verified insurance information is directly updated in your EMR or PMS. This seamless integration eliminates manual data entry, supports accurate billing, and ensures all coverage details are readily accessible at the point of care.
Tracking, Reporting & Follow-up
We help communicate benefits clearly to your patients, ensuring they understand their co-pays, deductibles, and coverage limitations. This proactive approach improves point-of-service collections and helps patients make informed care decisions.
Stat Requests Management
When urgency strikes, our stat verification process is ready. Submit a request through our secure portal, and we’ll immediately verify the patient’s insurance details, via online databases or by contacting the payer. Get the information you need within minutes to avoid care delays and ensure timely scheduling or authorizations.
Unique Benefits of Partnering with Us
Live Calls for Insurance Eligibility Verification
We go beyond automated portals by calling payers directly to confirm eligibility details. This real-time insurance eligibility verification eliminates guesswork and ensures timely and accurate billing.
Experience and Expertise
We provide patient eligibility verification for a wide range of plans including commercial health, Medicare, Medicaid, workers’ comp, dental, vision, and more. Our specialists understand the nuances of various insurance types and medical specialties.
Rapid Turnaround
Whether you need same-day verifications or urgent insurance details, our efficient team ensures fast turnaround times. That means fewer delays and more efficient patient scheduling.
Open Communication with Payers and Practices
Our team handles common payer issues, like incorrect policy info or expired plans, through proactive communication. This mitigates claim denials and streamlines the insurance verification process.
Seamless EMR Updation
We sync verified details directly into your EMR/PMS. By this process, you get to save your staff time, minimize possibilities for human error, and significantly improve compliance and revenue outcomes.
Improved Revenue Cycle
As we verify eligibility upfront, it automatically reduces rejections and payment delays. Our insurance verification services ensure better claim outcomes and faster reimbursements, directly improving your revenue cycle.
We serve all 50 states
Flexible and Affordable Pricing Plans
Choose from our flexible pricing plans based on your needs:
With rates as low as $2.00 per verification
Online Verifications
Rates as low as $2.00 per verification.
Automated real-time online verification for quick, accurate eligibility checks. Online verifications are designed for high-volume needs.
Phone Call Verifications
Rates as low as $3.00 per verification.
Customized phone call verification service, where our dedicated team of experts directly contact the patient’s insurance company for detailed coverage information.
FTE & Fixed Pricing Models
Full-Time Equivalent (FTE):
Services are billed based on the cost of a full-time employee (FTE) for a specified duration.
Services are billed based on the cost of a full-time employee (FTE) for a specified duration.
Fixed Cost Pricing:
Dedicates a person to your practice, providing consistent support.
Frequently Asked Questions (FAQs)
What is insurance eligibility verification?
Insurance eligibility verification is the process of validating a patient’s insurance policy before their appointment. It ensures the said treatment/procedure is covered, helping to reduce claim denials and improve billing accuracy.
Why is patient eligibility verification important for medical billing?
Patient eligibility verification is the first, vital step in the medical billing process. It helps verify coverage details such as policy status, co-pays, deductibles, and referral requirements; thereby ensuring proper claim submissions and faster reimbursements.
How do your insurance verification services work?
We collect patient insurance details, verify coverage via portals and live calls, update your EMR or PMS, and promptly notify your team of any issues. Our established, diligent process includes routine verifications and urgent (stat) checks when required.
What are the benefits of outsourcing insurance verification to your company?
When you outsource to us, we strive to improve your revenue cycle performance while helping you focus on patient care. We reduce your administrative burden, minimize claim rework, and ensure accurate verification with faster turnaround times.
Can you handle verifications for different insurance types and providers?
Yes. We provide insurance verification services for all major private and government payers, including Medicare, Medicaid, workers’ comp, regional insurers and specialty plans like dental, vision, and behavioral health.
What happens if a patient’s insurance can’t be verified before their appointment?
If coverage cannot be verified, we will immediately notify your team. We also assist in contacting the patient or payer to resolve the issue quickly, helping you decide whether to reschedule, collect payment upfront, or proceed with caution.
Do you support EMR or PMS integration for insurance verification?
Yes. We work directly within your software systems to update verified insurance data in real time. This seamless integration reduces manual entry errors and speeds up the billing process.
How long does the insurance eligibility verification process take?
Standard verifications are usually completed within 24 hours or less. However, stat requests are processed immediately, providing real-time results so your team can do instant scheduling or make treatment decisions.
What are the best practices for insurance verification in a medical practice?
Some of the best practices include verifying coverage at least 48 hours before the appointment, confirming all plan details (deductibles, co-pays, network status), updating your PMS/EMR promptly, and proactively communicating coverage info to patients.
Can I request urgent (stat) insurance verifications?
Yes. We offer a dedicated stat verification service for urgent cases. Just submit your request through our portal, and our team will verify and return coverage details in real time.
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