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Eligibility Verification Process

Healthcare Insurance Eligibility Verification Process

Medical billing companies have changed since 2010. Insurance Eligibility Verification is extra decisive today than always with the advent of the Affordable Care Act enacted in March of 2010. With ACA in place, the patient can have insurance one month and not pay their premium in following months.

Qualified health plans are obligatory to pay all claims for services provided in the first month of the grace period (eligibility). Carriers will pay out claims in the second or third months, at which point the patient must pay the provider for the services already provided or pay their insurance premium.

If the patient cannot manage to pay for the payment for their premium, then any physician claims pending during this second and third month will go unpaid causing an increase in bad debt collections.

The protocol of confirming the eligibility of a patient for the services that are being provided could minimize the denials to a greater extent. Denied claims due to non-coverage, out-of-network, unauthorized patient procedures or visits can incur a major loss in revenue and should never be taken frivolously.

Eligibility verification process can be consummated through a call to the Insurance companies, websites (payer or EDI) or through online software at present integrated with many EHRs.

Through accurate eligibility authentication, revenue cycle can be improved by reducing the number of rejections. There are missed opportunities to secure payment and increased staff time when the patient’s insurance eligibility is not validated before the service is rendered.

Personal information such as phone number, address and insurance coverage information is to be reorganized. Therefore, always verify the information on file is current and up to date.

These is where a medical billing business such as ours comes in handy.

At CodeMatrix MedPartners, Our medical billing specialist has been offering eligibility verification services to its clients very effectively. We offer complete set of medical billing process as part of the full revenue cycle management or as a ‘stand-alone’ medical billing service when required.

CodeMatrix is one of the top medical billing companies in texas, which  offers service at two levels –

At the first level is a basic insurance eligibility verification that gets coverage details of the patient in addition to the co-pays and deductibles.

The second level is to a large extent more in-depth and involves the gathering of CPT specific eligibility with annual max or lifetime limits and authorizations when obligatory.

Insurance eligibility verification, when leveraged with our medical billing and coding service, will increase clean claims, improve cash flow and compliance, minimize bad debt and increase patient satisfaction.

Charge Entry Process 

We follow a simple medical billing process with integrated, client-customized systems which help us handle claims related to a wide variety of health plans as well as medical, vision, prescription drugs, dental, disability, and COBRA claims.

Why Choose CodeMatrix MedPartners?

Of the many medical billing outsourcing companies we are unique and offers the following support:

  • Decrease the time taken for claims filing and processing and increase your revenue by more than 20%
  • Reduce administrative overheads
  • Get access to robust processes that ensure a high degree of accuracy and increase your chances of recovering the claims
  • Get periodical reports on claim statuses as well as work-in-progress
  • Detect any duplicate claims
  • Get access to fully automated payment solutions
  • Minimize compliance issues

As one of the best medical billing business, we take pride in what we do. Get your bills paid faster with the help of  medical billing specialist like CodeMatrix. 

Payment Posting Services

One of the final steps of the medical billing process – payment posting, is imperative for an optimized revenue cycle. Once payments are posted to patient accounts, any denials can be addressed following accurate payment posting methods. At the same time, quick turnaround time and attention to detail are important aspects of the payment posting task and cannot be performed easily by just anyone.

Why Choose CodeMatrix?

Here are some reasons why you should choose CodeMatrix for your medical billing outsourcing;

  • We post claims accurately that highlights overall billing efficiency reasons for low inflows
  • Depending on the rate and nature of denials we implement our denial management expertise to sort the problem and bring down the rate of denials
  • We have the domain expertise as well as the experience to maintain the accuracy of information as per our client’s requirements

What are you waiting for? Avail the services from one of the best medical billing service in Allen Texas. Outsource your medical billing to CodeMatrix now!