Eligibility & Benefits Verification Services

Ensure financial clarity, minimize denials, and optimize patient care from the very start with our expert eligibility and benefits verification services.

Step Into Smarter RCM with I-Conic Solutions

Stop Revenue Loss Before it Starts

Medical practices lose $125 billion annually to claim denials, with 65% caused by insurance eligibility and benefits verification failures. Are you facing 15-20% denial rates and frustrated patients receiving unexpected bills after treatment? Without proper benefit verification in healthcare, practices struggle with revenue loss while patients abandon care due to billing surprises. I-Conic Solutions prevents these issues by verifying coverage, authorization needs, and patient responsibility upfront, ensuring smooth billing and satisfied patients.

Reasons to Outsource Insurance Eligibility
Verification Services to I-Conic Solutions

To outsource insurance eligibility verification services to us offers unparalleled RCM advantages.

Unmatched Accuracy

Our dedicated experts ensure precise verification, minimizing errors that lead to denials.

Significant Cost Savings

Reduce operational overhead, labor costs, and the expenses associated with claim denials.

Accelerated Cash Flow

Faster verification means quicker claims, leading to improved reimbursement speed.

Expert Team

Benefit from a highly trained team specializing in medical insurance verification across diverse payers.

Advanced Technology

We leverage sophisticated payer portals and clearinghouses for efficient, real-time eligibility checks, akin to the best medical insurance verification websites.

Focus on Patient Care

Free your internal staff to concentrate on what matters most – delivering exceptional patient experiences.

Scalability & Flexibility

Our services adapt seamlessly to your practice’s growth and fluctuating patient volumes.

Comprehensive Coverage

We handle co-pay/deductible details capture, out-of-network alerts, and policy limitation checks for a complete picture.

Robust Documentation

All benefit details are meticulously documented, providing crucial audit support.

Dedicated Partnership

We act as an extension of your team, committed to your long-term Revenue Cycle Management success.

Eligibility and Benefits Verification Process

Step 1: Patient Data Intake

We securely receive patient demographics and scheduled appointments.

Step 2: Real-Time Eligibility Checks

Using real-time eligibility checks through advanced payer portals & secure clearinghouses, we confirm active coverage, like medical insurance verification websites.

Step 3: In-Depth Benefits Verification

Verifying insurance benefits, including all essential co-pay/deductible details capture, co-insurance, out-of-pocket maximums, and policy limitations.

Step 4: Prior Authorization Assessment

We identify if prior authorization is required for the scheduled services, noting all specific payer requirements.

Step 5: Out-of-Network Alerts

Our system provides proactive out-of-network alerts if a patient's plan has limited or no coverage with your facility.

Step 6: Direct Payer Engagement

For complex cases or ambiguous policy details, our specialists contact insurers directly for the most accurate information.

Step 7: Reporting & System Updates

We create and share detailed verification reports, which we use to update your practice management system for accurate billing.

Consequences of Failing Healthcare Insurance
Eligibility Verification

High Claim Denial Rates

Delayed Patient Collections

Increased Accounts Receivable (AR)

Negative Patient Experiences

Administrative Rework

Cash Flow Instability

Audit Exposure

End-to-End
Eligibility & Benefits Verification Services

Proactive Eligibility Checks

Verify the patient’s eligibility and benefits, and obtain prior authorization determinations before the patient visit, flagging services that require pre-approval.