Eligibility Verification & Pre- Authorization

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Eligibility Verification & Pre- Authorization

Eligibility checks also play an important

role in the effective submission of error-free applications. One of the biggest benefits of this system is that it allows you to improve patient satisfaction by avoiding repeat requests. Meanwhile, you can easily develop collections of different funds and turn your trades into profitable opportunities Double check, ie. primary and secondary coverage, is a top priority for AMED RCM professionals. In addition, this system includes advanced information such as patient number, group ID, insurance period and insurance eligibility to provide great benefits to the patient.

In any case, if the information is incorrect and missing, we will try to contact the patient immediately to remove all our doubts and maintain the best structure of information about the patient. However, you can always rely on us for additional services such as POS and PCPs and get a complete control solution from us.

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.

Most people believe in authorization because it supports healthcare organizations in handling the appropriate payment methods so you can intelligently reduce denials.

The most effective methods are available, which always consist of a smoother pre-authorized process, such as: –

At Amed RCM, our experienced Eligibility Verification Specialists electronically verify benefits or use automated systems to gather patient information ahead of their visit. We follow these steps 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.

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