The verification of patients’ eligibility and prior authorization is a complicated and recurring process executed almost 365 days a year. To secure payment for services delivered, healthcare providers must validate every patient’s eligibility and benefits before the visit. Estimates show that as many as 75% of claims are denied due to patients being ineligible for the services provided. Unfortunately, this is one of the most overlooked procedures in revenue cycle management. Eligibility verification and prior authorization in medical billing are crucial for appropriate payment collection, and decreasing denials and follow-ups.
Ineffective eligibility verification processes can lead to increased claim denials, overdue payments, additional revisions, delays in patient care, reduced patient satisfaction, and non-payment of claims.
The Medicator can help you confirm whether a specific medical procedure is covered and obtain prior authorization from payers when needed, ensuring timely and appropriate reimbursement. Our qualified insurance verification experts contact insurance firms and obtain approvals efficiently. We handle real-time eligibility verification and gather necessary documentation for prior authorization requests.
The Medicator is a leading insurance authorization enterprise, working with all private and government insurance companies. We gather comprehensive information about eligibility verification processes and work to obtain pre-authorization rapidly. Our team ensures that payer standards are met before submitting requests and can estimate how long it will take to verify and approve pre-authorizations. We confirm that all requests are submitted with the required documents.
You must receive reimbursement for the care you deliver. We manage the eligibility verification and prior authorization process, allowing you to focus on patient care. By streamlining your billing process, we help ensure you get paid faster and more smoothly.
Maintaining up-to-date eligibility data significantly improves the approval and processing speed of claims. This leads to reduced denials and write-offs, ensuring a more reliable cash flow for practices. With our eligibility and benefits verification services, we enhance your revenue cycle and optimize collections.
Our eligibility verification and prior authorization services help minimize claim denials, resulting in a faster cash flow. By ensuring accurate verification, both insurance and patient coverage are aligned, leading to maximum approval rates and fewer claims denials. Let us streamline your processes to enhance revenue and efficiency.
Clearly defining patient payment responsibilities significantly lowers outstanding balances. Our proactive bad debt management approach provides patients with every feasible financial resource, enabling healthcare systems to focus less on collections and more on care. This strategy helps to improve revenue cycle efficiency and reduces financial losses.
By closely monitoring eligibility responses, we enhance the overall efficiency of medical billing processes. This leads to improved patient engagement and ensures a reliable, streamlined method for claims processing. We manage the entire process at less than a third of the costs, maximizing your revenue potential while minimizing expenses.
