Eligibility Verification & Pre- Authorization
Eligibility Verification is a prerequisite for the applications’ submission process to be accurate and free from any errors, thus, improving the patient’s satisfaction due to the fewer repeat requests. This method facilitates healthcare providers in the collection of dues and consequently the improvement of the financial performance. With Amed Rcm, we are a team that is proficient in Eligibility Verification, confirming that both primary and secondary coverages are accurately verified. We process sensitive details such as patient numbers, group IDs, periods of insurance, and the eligibility of insurance to give the patients the best benefits.
If the information is wrong or not enough, our team number one contacts the patient to fix the problems so that the records are accurate and up to date. Besides this, our services also help Point of Service (POS) and Primary Care Physician (PCP) verification, giving a full solution to managing the account effectively.
On the other hand, prior authorization is the best system that includes a better healthy revenue cycle management process to maintain it more efficiently. We all know that this process takes place after the verification system. So, whatever question you have about it, you can meet Amed Rcm solutions and get the best encouragement from them.
The most effective methods are available, which always consist of a smoother pre-authorized process, such as:
- Better management of the approval process so that you know the important services that may involve a certain procedure.
- Proper maintenance of all types of important documents and data repositories so that you can handle every step without problems.
- Correct understanding of important contract terms and processes to achieve the best result in a short time
Our experienced Eligibility Verification Specialists ensure that patient benefits are accurately verified before each visit. Using electronic verification methods or automated systems, we gather comprehensive patient information ahead of time to streamline the process. We follow these detailed steps to ensure seamless service for your group
- We obtain a list of new patients prior to their appointments and verify coverage with primary and secondary payers using websites, Automated Voice Response, and phone calls as needed.
We conduct the verification service, which involves determining:
– Member and Group ID’s
– Effective and termination dates of coverage
– Co-pays
– Co-insurance
– Plan exclusions
– Referrals and pre-authorizations
– Deductibles
– Plan type and coverage specifics
– Payable benefits
– Patient policy status
– Benefit maximums
This comprehensive verification process ensures a seamless and trouble-free experience for both your patients and your practice.