Eligibility and insurance verification are vital to ensuring the accurate receipt of information regarding coverage. Without proper checks, a healthcare organization could be leaving money on the table-failure can lead not only to delayed payments but also denials, which results in decreased collections for them or even worse: no revenue at all!

ELIGIBILITY AND BENEFITS VERIFICATION SERVICES

• Workflows received through the patient scheduling system, EDI, Fax, emails, and FTP files
• Accurate verification of primary and secondary coverage details, including member ID, group ID, coverage period, co-pay, deductible, and co-insurance and benefits information
• Efficient connection with the payer using the best possible channel (phone or web)
• Prompt identification and resolution of missing or invalid data
• Upgrade eligibility verification processes with our proprietary RPA tools.

PRIOR AUTHORIZATION

• Rapid determination of prior authorization requirements
• Prepare and submit paperwork to the payer
• Consistent follow-ups on submitted prior-authorization requests
• Immediate notification of any issues with the authorization request

US24 HEALTHCARE SOLUTIONS VALUE ADDITION FOR ELIGIBILITY VERIFICATION SERVICES

• Better patient satisfaction
• Optimized cash flow
• Reduced patient-related denials
• Avoided rejection of claims by payers due to inaccurate or incomplete information
• Identification of the patient’s responsibility upfront