Eligibility Verification

Physicians need to verify each patient’s eligibility and benefits to ensure they will receive payment for services rendered. We offer comprehensive patient eligibility verification services to help healthcare providers check coverage prior to the office visit. Our focus is on preventing denials and avoiding delays in payment, which will boost revenue at the time of service, save time on the back end, and also enhance patient satisfaction.

Our health insurance eligibility verification specialists will confirm the following patient benefits on each date of service:

• Coverage Verification– whether the patient has valid coverage or not
• Demographic data – Patient Name & DOB is same as Payer
• Benefit options – patient responsibility for co-pays and coinsurance
• Plan Type – Verify patient plan type to avoid future denial
• Prior authorization requirements – confirming authorization for treatment from appropriate sources, if applicable

Insurance Eligibility


Ascertain Coverage

Obtain Prior Authorization

Identify Policy Exclusion