Verification of insurance benefits

We verify and collect accurate patient demographic information, including name, address, date of birth and insurance details. Confirm the patient's health information, insurance coverage and policy information.

We verify the patient's insurance coverage and eligibility before providing services. Confirm the patient's plan details, including deductible, co-pay and co-insurance information. Check for any pre-existing conditions or limitations in coverage.

We ensure pre-authorization or pre-certification requirements are met for specific medical procedures or services. Confirm the validity and approval of any required authorizations.

We generate and submit accurate insurance claims electronically or through the appropriate channels. Include all necessary supporting documentation and codes required for reimbursement.

Adhere to insurance company deadlines for claim submission to avoid claim denials due to late filing. We monitor and track claim submission timelines for each insurance payer.

We are implementing a robust denial management process to address and appeal denied claims promptly. Analyze denial patterns to identify root causes and implement corrective actions.

We are implementing a robust denial management process to address and appeal denied claims promptly. Analyze denial patterns to identify root causes and implement corrective actions.

Verify and coordinate benefits when a patient has multiple insurance plans. We determine the primary and secondary payers and ensure proper billing to each.

Utilize EDI capabilities for electronic communication between healthcare providers and insurance companies. We ensure compliance with EDI standards to streamline claim processing.

We regularly reconcile accounts and audit claims to identify discrepancies or potential issues. Conduct internal and external audits to ensure compliance with regulatory requirements.

We provide ongoing training to staff members involved in the revenue cycle to stay updated on insurance industry changes, coding updates and best practices.

Ensure compliance with contractual agreements with insurance providers. We monitor fee schedules, reimbursement rates and any specific requirements outlined in provider contracts.

Utilize integrated healthcare information systems to facilitate seamless communication and data exchange between different revenue cycle stages.

We communicate with patients about their insurance coverage, co-pays and financial responsibilities. Educate patients on the importance of providing accurate insurance information during the registration process.