We call the insurance company, ask all the right questions and spend as much time as needed to get you detailed patient benefits information before you start treatment. In return, you stop worrying about claim denials and slash your front desk workload by 50%. We become an extension of your clinic. The result - Happy patients, happy staff and more money in the bank for you.
Not having accurate (and comprehensive) eligibility and benefits information is THE number one reason for claim denials.
Denial reasons include benefit caps, policy/coverage is no longer active, authorization is denied, and non-covered services. This results in denials, rejections, and even permanent loss of income due to delayed or improper submission.
Some clinics deal with this by having staff stay on the phone, for 30-45 minutes or more, as they try to get answers from an insurance company.
Others rely on technology for eligibility information online, but the information from online portals is not always accurate, and in most cases, incomplete. We present you with a new way that is cheaper, and more efficient.
We Slash Your Front Desk Workload by Upto 50%
You provide us with these data points about your patient:
Date of Birth
Patient's Insurance ID
Insurance Group Number
Leave the rest to us.
No need to call the payers.
Focus on patient treatment and patient satisfaction. Get paid. We become an extension of your clinic.
We call the payer, and get you the following in a secure, encrypted manner, mostly within 2-4 hours.
Verification of correct policy number and group number
Policy effective dates & current status
Type of policy and services covered
Deductible limit and utilization in current period
Therapy cap met / not met by the patient
Services that are excluded from coverage payment
Paper claim mailing address and phone number
Claims adjusters name and phone number
Requirement for pre-authorization or referrals
In network benefits (if the patient is in network)
Out of network benefits (if the patient is out of network)
Imagine a day in your clinic where every new patient had eligibility verification done and available to you, without a single member of your staff spending a minute on hold with an insurance company - all for a fraction of the cost of checking patient benefits in-house.
Eligibility Verification is a powerful and effective service to combat claim denials for reasons such as 'non-covered service' and denials due to lack of eligibility.
A Happy Practice
You'll see lower denials and a happier, more productive staff. A happy practice makes more money.
Our service includes a summary of communication with the payer and provides you with all relevant information - in many cases, before a patient walks into your clinic.
We have a large team of specially trained callers who pick up the phone and call the appropriate insurance companies for every single patient and provide you with detailed information before you start treatment.
The number one cause of claim denials - unknown eligibility, is eliminated. Watch your first-pass rate and reimbursements skyrocket.
It costs less to invest in our specially trained team to handle eligibility calls than to have your internal staff waste time on the phone.
Increase your staff efficiency
Your staff should be spending time on high-value tasks that improve patient experience and grow your practice, not sitting on hold with an insurance company.
You get current information about all patient benefits and can be assured that your claims won’t be denied due to eligibility issues.
Leave the long calls to us
Whether it takes us 5 minutes or 60, we'll stay on the phone with the payer as long as needed to to get you all the information to submit a clean claim and get paid. When you use our eligibility verification service, you’ll save money, collect more from payers, and grow your practice.
The cost is $6 per patient with a monthly minimum of 100 patients.
If this number is not reached, we will charge the minimum charge for 100 patients, which is $600 for that month. No carry forward.
Our pricing model is simple and transparent - no contracts and you can cancel anytime.
If you pay a staff member $13/hr, and they spend 30-45 minutes getting eligibility information, entering this information into your EMR and filling out authorization forms, you've now invested about $8 into the eligibility verification for that patient, and you may still end up with incomplete / inaccurate information.
We Make the Calls
We call the payer, and stay on hold for as long as it takes to get you the information you need.
We Know What to Ask
We know exactly whom to call, and what to ask. You'll have the information the second we do.
We Stay Current
Payers regularly make policy changes without notifying you, and most patients don’t know their current policy benefits. Leave this to us.
No Fine Print
Month to month. No contracts. Keep us around if you're happy.
Secure, Encrypted Data
We use a 100% secure, encrypted HIPAA protected communication channel to send you all patient data.
We verify all patient benefits, so you can discuss payment options with patients before beginning treatment.