Insurance Eligibility Verification

Medenar Healthcare is a well-known supplier of healthcare services and medical billing.

Insurance Eligibility Verification

Insurance eligibility verification is the most important and the first step in the medical billing process. Research confirms that most of the claims are denied or delayed due to inadequate or incorrect coverage information provided by the patients during visits and current coverage information not updated by the office / hospital staff. This lack of improper insurance eligibility verification directly impacts the reimbursements.

For Enquiry

Insurance companies regularly make policy changes and updates in their health plans. Therefore, it is important for the medical billing company or the provider to verify if the patient is covered under the new plan to get maximum reimbursement. Confirming the insurance coverage facilitates acceptance of the claim on the first submission, whereas non-verification leads to several discomforts like rework, decreased patient satisfaction and increased errors other than causing delays and denials.

Receive Schedules of patients via EDI, email or fax or check them every day in the appointment scheduling software. 

Health Insurance Document Verification

We collect the insurance documents, verify the name of the insured, SSN number, age, start and end date of the policy, the current status of the policy, and other details to confirm benefits and patient enrolment.

Patient Insurance Coverage Verification

This service helps you check insurance coverage and other necessary details like co-insurance, co-pay, deductible, PCP name matching, in-network, and out-of-network benefits, and updates in the patient note.

Patient Information Correction

Our resources follow up with the patients for missing documents or call them to get confirmation and updates on incorrect or missing information/documents. This checks for the patient’s active plans before enrolment.

Seek Prior Authorization

Once the documents are verified and credentials established, we get in touch with the insurance carrier to seek authorization for the procedure. This increases the authenticity of the patient’s claims and prevents instances of denials.

Optimizing Claims Submission

We cross-verify the diagnoses, treatment plans, and other details before submitting the claims to the carrier. This determines the amount to be reimbursed and the timely payment posting.