Why you should very Eligibility?
Having access to the most up-to-date eligibility and benefits data increases clean claims rates, eliminates costly rework and accelerates reimbursement.
Physicians can take advantage of a fully integrated insurance and benefits verification offering that increases time-of-service collections, minimizes bad debt and boosts patient satisfaction
Eligibility responses are viewed in a concise and consistent format that improves efficiency. Providers apply custom business rules and analytics to returned payer data, and automatically receive notifications when edits or follow-up are required.
Capitalize on additional reimbursement opportunities by electronically matching self-pay patients against Medicaid and Managed Medicaid databases. After identifying any individuals who may unknowingly have coverage, providers can reclassify these patients and submit claims, which is often the quickest way to secure payment.
- Decreased A/R days
- Cleaner billing system data
- Reduced registration, co-pay and billing errors
- Lower billing and collections costs
Eligibility Verification / Pre-Authorization Services
An efficient revenue cycle management begins with the implementation of best process practices. We believe in proactive measures and clearly understand reacting on claims denied after 15-30 days of submission does not help the cash flow of our clients.
Our Eligibility Verification and Pre-Authorization services eliminate claims being denied for “Non-Covered services”, “No Coverage at the time of services”, “Procedure requires referral or authorization” and more. Many denials can be eliminated by proper coverage verification and by obtaining referral/authorization prior to providing the services.
- Receive Schedules of patients via EDI, email or fax or check them every day in the appointment scheduling software.
- Verify patients’ insurance coverage with primary and secondary payers by making calls to the payers and checking through their authorized online insurance portals. We also contact patients for additional information, if required.
- Update the medical billing system with eligibility and verification details such as member ID, group ID, coverage period, co-pay, Deductible and co-insurance information and other code level benefits information including max limits allowed.
In case of issues regarding a patient’s eligibility, we inform the client immediately.
GBS’s dedicated insurance eligibility verification team delivers a thorough verification, thereby aiding dramatic reduction of the clients’ accounts receivable cycle.