Our Services
Eligibility Verification Services
Accurate Insurance Checks Before Every Appointment
Unexpected claim rejections often start with missing or outdated insurance details. Practice Claim’s eligibility verification service ensures every patient’s coverage is confirmed before they step into your clinic. We verify policy status, benefits, limitations, and patient responsibilities so you avoid last-minute surprises and costly revenue loss.
Our Eligibility Verification Services
The Patient Eligibility Verification Services that we offer include full solutions to your practice requirements. Here’s how we can support you:
We verify patients’ insurance information instantly and help you determine coverage, co-payment, and deductible along with benefit information. It saves time and minimizes the chances of mistakes, so there are no unexpected results further in the process.
Our service identifies the patient’s primary and secondary insurance plans and checks their authorization with the insurer. These involve active policy, patient status, restrictions, or limitations on services amongst others.
All necessary authorization requirements are checked before services are offered to clients. By reviewing the previous authority and verifying it with the insurer, we ensure that there are no postponed or denied claims or services.
Our solution is also fully compliant with EHR/EMR systems to allow minimal data entry from your end. These integrations also help to speed up verifying, which will free up your staff’s time to be more dedicated towards the well-being of their patients.
We provide detailed eligibility reports that will give a detailed outlook on a patient’s insurance, co-payment, deductible and other financial aspects. We also provide you with industry trends that will assist you in managing your practice’s revenue cycle.
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Our Eligibility Verification Process
The Eligibility Verification process at Practice Claim is more than a standard procedure, it is a certified and validated method that supports the highest compliance standards. The process generally consists of the following steps:
Collect Patient Information
- We first gather relevant patient data such as insurance details, member identification numbers, and other identification from your EHR/EMR system, fax or direct input. These are then transferred to the payer through a secure channel for an eligibility check.
Verify Insurance Coverage
- As soon as we obtain the patient’s details, we contact the insurance payer for immediate confirmation. This includes verifying primary and secondary coverage, co–payments, deductibles and exclusions. If the payer has any other additional conditions, they are also communicated to you immediately.
Check Prior Authorization
- If there are certain services that require the patient’s prior authorization. This information is obtained directly from the insurance companies in order to be certain whether the appropriate approvals have been issued.
Update Data and Report
- Once you receive results from the insurance company, the system is updated with actual data about your eligibility. This enables us to offer comprehensive reports so you can determine the status of your patient’s insurance.
Issue Eligibility Report
- We produce an eligibility report with summary of the insurance coverage, the copay and deductible, and excluded service as well as prior authorization. You'll have access to this information before proceeding with services to ensure that all necessary details are confirmed.
Benefits of Outsourcing Eligibility Verification Services
Utilizing Practice Claim to assist in completing the
process provides various ways that increase the effectiveness and profit of your facility.
Shorter Approval Times
Accelerated processing with consistent follow-ups
Improved Reimbursements
Better payment terms from in-network enrollment
Complete Compliance
All documents prepared to meet federal and state standards
Minimized Administrative Tasks
We handle forms, calls, and negotiations for you
Access to Premium Networks
Opportunities to join top-tier payer panels
Minimize Claim Daniel
Accurate submissions reduce rejections and payment delays
